Tuesday, November 2, 2010

From the womb to the world...It is 'sense'-ational.

While your baby is safe in your womb, they are used to very different sensations than they experience in the daily routines after they are born! Understanding what was comforting for your baby in the womb may help in making baby's transition to the real world more smooth. We all need to be touched and for most people touch (the right kind of touch) is very comforting. In the womb a baby is not exposed to light touch instead they are hugged in a squishy tight space with the constant reassuring sound of mom's heart beat and regular gurgling from whatever mom is digesting. The womb provides the perfect amount of pressure and vibration to calm and comfort baby.

After that the sensory real world can feel quite hostile and uncomfortable! Bright lights, different textured cloths, water, doors slamming, dog barking, unpredictable touches and the cold wet wipes!! Is it any wonder why some babies do not want to come out!

When I baby is having a difficult time settling think about the sensory environment and how can you recreate some of the same sensations that baby experienced in the womb.

Thursday, April 8, 2010

Week Eighteen

Your Baby's Development

Ears move to their final position and they stand out from the head. And start brushing up on your lullabies — in the coming weeks, your baby will probably be able to hear! The bones of the middle ear and the nerve endings from the brain are developing so that your baby will hear sounds such as your heartbeat and blood moving through the umbilical cord. He or she may even be startled by loud noises! Your baby's eyes are also developing — they're now facing forward rather than to the sides, and the retinas may be able to detect the beam of a flashlight if you hold it to your abdomen.

Until now, your baby's bones had been developing but were still soft. This week, they begin to harden, or ossify. Some of the first bones to ossify are those in the clavicles and the legs.

Your Body

You're probably beginning to prepare for life with baby. Your preparations should extend beyond gathering the layette and decorating the nursery, though. This is a good week to begin your search for a pediatrician or other health care provider for your child. Schedule visits to meet with potential doctors to discuss issues such as appointment availability, immunization scheduling, and when to call in an emergency. You'll also want to learn as much as you can about their practices and procedures.

Some good questions to ask: How many health care providers are in the practice? Who covers nights and weekends? What is their policy on phone calls? Which hospitals are they affiliated with? What insurance do they accept? What specialists do they work with? How are emergencies handled?

It's important that you feel comfortable with your child's doctor, so do your homework and make your decision carefully.

Wednesday, April 7, 2010

Breast Changes in Pregnancy

You may have heard that one of the first pregnancy symptoms many women have is changes to their breast tissue. It is true that your breasts will respond to you being pregnant by changing in preparation for breastfeeding. Here are some of the more common changes in your breasts during pregnancy:

* Sore Breasts

Early in the first trimester you may notice that your breasts are sore or tender. For some women this is also a sign of an impending period, so it may go unnoticed. You may have a slight tenderness when you touch your breasts or you can have the severe pain whenever you wear a bra. Both variants are normal and are usually most intense in the first trimester. This is one of the reasons that sex in the first trimester is often avoided by some women. Sex in pregnancy is safe, you may just want to avoid having anyone touch your nipples.

* Nipple Changes

Your nipples may become larger and darker as your pregnancy progresses. You may also notice small, goose bump or pimple like white areas on your areola. These are normal. They are called Montgomery's tubercules.

* Larger Breasts

Towards the end of the first trimester or the beginning of the second trimester you may notice that your breasts begin to grow. This is again the tissues inside the breast preparing for nursing. Towards the end of pregnancy you will want to be fitted for a nursing bra to help accommodate the larger breasts.

* Leaking Colostrum

Colostrum is the first milk your body makes. It will provide your baby with everything he or she needs to start life, including a dose of immunities and protection from jaundice. Towards the end of pregnancy some women may find that their breasts leak this golden color fluid. Or you may notice that your nipples have a film or caked substance, this is all colostrum. You can use a breast pad if it becomes noticeable or if it makes you feel more comfortable.

* No Breast Changes

You may be one of the women who have only slight symptoms or no symptoms of breast changes in pregnancy. Don't panic. It has nothing to do with your ability to have a successful pregnancy or breastfeeding relationship.

Tuesday, April 6, 2010

Week Seventeen

Your Baby's Development

At about 5.1 inches (13 cm) from crown to rump and weighing 4.9 ounces (140 grams), your baby is still very tiny.

The placenta, which nourishes the fetus with nutrients and oxygen and removes wastes, is growing to accommodate your baby. It now contains thousands of blood vessels that bring nutrients and oxygen from your body to your baby's developing body.

Your Body

You may notice that your breasts have changed considerably since your pregnancy began. Hormones are preparing your breasts for milk production — more blood is flowing to the breasts, and the glands that produce milk are growing in preparation for breastfeeding. This can increase your breast size (many women increase one to two cup sizes) and cause veins to become visible. Buy supportive bras in a variety of sizes to accommodate your breast growth during pregnancy.

Monday, April 5, 2010

10 ways to survive stress in pregnancy

The sources of stress during pregnancy can be wide ranging, from concern about your baby's health and wellbeing, or the impending labour, through to how you'll manage after the birth. It could be that your journey to work is exhausting, or you're anxious about finances and how you are going to afford all the costs involved with a new baby. Whatever it is that's worrying you, there are many positive steps you can take to overcome these feelings.

1. Make time to rest

It's a simple thing, but sometimes so difficult to take time out for yourself. Not only is this good for you, but also extremely good for your baby - so don't feel guilty about 'doing nothing'.

At work, find somewhere to put your feet up and relax during your lunch break and, in the evenings, try to cut down on chores. Leave the laundry until the weekend, and forget about housework for a while. Obviously, if you have a child already it can be hard to find the time to rest, so why not get your partner, a friend or grandparents to amuse them for an afternoon, while you have a well-earned break?

2. Prenatal yoga

Yoga during pregnancy not only helps tone your body, but the relaxation techniques that will assist you in labour can have a beneficial effect during pregnancy. If you are prone to feelings of anxiety or have experienced panic attacks, practising your breathing techniques can really help.

3. Talk about it

If you are worried about whether your baby is healthy or whether he will be born safely, you're certainly not alone. Talking about these concerns will really help, whether it's with your partner, mother or a friend who already has children. Other women at the same stage of pregnancy as you, perhaps at your prenatal class, will undoubtedly share your concerns, and your midwife, doctor or prenatal teacher can also reassure you.

4. Relaxation and complementary therapies

Massage in pregnancy is a fantastic way to de-stress. The cost of a registered massage therapist is covered by many health plans in Canada and there are lots of books available with tips and advice on how massage can help you relax.

If you are using aromatherapy or essential oils, it's important to make sure they are safe for use in pregnancy as some are not suitable for the first or third trimester. Oils safe for use after 20 weeks include most lavender oils, citrus oils and ylang ylang, but you should check with a qualified aromatherapist.

Reflexology is also a great way to relax, but make sure the therapist is qualified in working with pregnant women.

Some moms-to-be find that Bach Flower Remedies, available from health food shops or pharmacies, can help with feelings of stress or panic, particularly the Walnut Remedy and the Rescue Remedy.

Meditation and positive visualization techniques can also help. Meditation is a way of relaxing by concentrating on a mental focus, and positive visualization is a technique for releasing anxieties by creating an inner picture of a peaceful scene. You can find books in your library that show you how to relax in this way if you haven't tried it before. Buy some special relaxation tapes to play in the background - great for helping your mind switch off. Choose a time when you know you won't be disturbed and try to give yourself at least 30 minutes.

5. Preparing for the birth

You may be worrying about the impending labour and how you will cope with the pain, whether you will make a fool of yourself or how your partner will cope. Find out about the mechanics of labour as well as the physical and emotional aspects of each phase by signing up for antenatal classes, reading books and magazines and gathering information from online. Being informed will help you feel more confident and in control.

If you are having your baby in hospital, it will also help to visit the labour and delivery rooms beforehand, so that you know what to expect.

For a few women, the fear of childbirth can be so overwhelming that they would rather have a caesarean section than a normal delivery. This fear is known as 'tocophobia' and is not uncommon. Tell your midwife or doctor about your fears. Research has shown this can be helped with the right counselling and support; cognitive behavioural therapy is one of options available which might help.

6. Relationship changes

It's perfectly understandable to worry about how having a baby will affect your relationship with your partner or how you will cope as a parent. Parenting is something you learn along the way and often there is no right or wrong way to do things, you just have to do what feels right for you. Try and spend some time with a friend who has a young baby to pick up some useful tips and ideas. If you have any anxieties about your finances, job, relationship or housing, speak to your midwife as she will know which local organizations or support groups you can contact for advice.

7. Commuting strategies

Like a lot of women these days, you may plan on working until just a few weeks before your due date because you want more time off with your baby after he's born. Experts agree commuting is one of the major sources of stress for expectant moms and one which is made worse the more heavily pregnant you are.

Ask your employer if you can avoid rush hours, particularly if you use public transit. Perhaps starting work earlier and finishing earlier would be possible, or even working from home one or two days a week.

Make sure you always sit down while travelling and if you are not offered a seat you should ask for one. Don't feel embarrassed - it's really not safe to be swinging around in a train, subway or bus - and most people are more than willing to give up their seats, they just need to be reminded sometimes.

8. Money matters

The knock-on effect of having a baby is the dent it makes in your finances. If you are worried about how you are going to afford everything, make a list of the items you need - in order of priority - then decide which ones you could borrow from friends or family. It really isn't necessary to buy everything, particularly when some items are often only used for a couple of months.

Make sure you get your full entitlement of maternity leave and pay. Find out what it is from your personnel department and don't be afraid to seek further help if you need more advice.

9. Diet and exercise

Eating calming nutrients can help suppress the hormones that rise at times of stress. Foods containing B vitamins, such as yeast extract, wholegrain bread and wholegrain rice, increase your levels of the anti-stress hormone serotonin. Ensuring that you eat well in pregnancy is very important.

Physical exercise also has proven benefits in terms of relieving tension, so continue with the exercise you did before you were pregnant -- so long as it is safe for you to do so. If you're in any doubt, check with your doctor. If you attend exercise classes, always inform your teacher that you are pregnant.

Swimming is the perfect exercise for pregnancy as it keeps you toned and healthy, without being too hard on your joints, although be careful with excessive breaststroke as it may cause backache. Aquarobics classes for pregnant women are also a fun way of keeping fit.

At work, make sure you get up and walk around regularly, especially if your job is mainly desk-bound, and pop out at lunchtime for some fresh air, even if it's only for ten minutes.

10.Treat yourself

Laughter is one of the body's best ways of relaxing, so meet up with some friends or go to the movies and see the latest comedy.

Go on a weekend break and make the most of your time with just you and your partner, or treat yourself to a spa that offers treatments for pregnant women.

Pregnancy is also the perfect time to treat yourself to all those beauty treatments you never normally splash out on. When your bump gets too big for you to cut your toenails, enjoy regular pedicures, instead.

Be nice to yourself -- you deserve it.

Thursday, April 1, 2010

Week Sixteen

Your Baby's Development

Your baby now weighs about 3.9 ounces (110 grams) and measures about 4.7 inches (12 cm) in length from crown to rump. Your baby can hold his or her head erect, and the development of facial muscles allows for a variety of expressions, such as squinting and frowning.

Your Body

Between weeks 16 and 18 of pregnancy, your health care provider may offer you the maternal blood screening test, also known as a "triple marker" test or "triple screen," which measures the levels of alpha-fetoprotein (AFP), a protein produced by the fetus, and the pregnancy hormones hCG and estriol in the mother's blood. The test is sometimes called a quadruple screen when the level of an additional substance, called inhibin-A, is also measured. The results of these tests can tell moms whether their babies are at risk for (not whether they have) neural tube defects such as spina bifida or chromosomal abnormalities such as Down syndrome. Out of every 1,000 women who take these tests, about 50 will have abnormal results, but only one or two women will actually have babies with a problem. Talk to your health care provider about the risks and advantages of these tests.

Tuesday, March 30, 2010

Week Fifteen

Your Baby's Development

Parents are often amazed by the softness of their newborn's skin. Your baby’s skin has been continuously developing, and it is so thin and translucent that you can see the blood vessels through it. Hair growth continues on the eyebrows and the head. Your baby's ears are almost in position now, although they are still set a bit low on the head.

Internally, your baby's skeletal system continues to develop. Muscle development continues too, and your baby is probably making lots of movements with his or her head, mouth, arms, wrists, hands, legs, and feet.

Your Body

Has it sunk in yet that you're pregnant? Many women say that it isn't until they trade in their jeans for maternity clothes and others start noticing their swelling abdomens that the reality of pregnancy sets in. For many, this realization is both joyful and scary. It's normal to feel as if you're on an emotional roller coaster (you have your hormones to thank). Another thing you may be feeling? Scatterbrained. Even the most organized women report that pregnancy somehow makes them forgetful, clumsy, and unable to concentrate. Try to keep the stress in your life to a minimum and take your "mental lapses" in stride — they're only temporary.

Monday, March 29, 2010

Prenatal Testing

There are many tests that can be done throughout pregnancy to make sure that you and your baby are progressing well. Some of these tests are done routinely and others are done if there is concern about the well-being of the baby.

Routine testing

A number of tests are done routinely during pregnancy. These include urine tests, blood tests, a Pap smear, an ultrasound, and tests for gestational diabetes and Streptococcus B.

Blood tests (first medical visit)

Blood tests are done to confirm the pregnancy and to check for a number of things, including iron, infectious diseases, immunities to other infectious diseases, and rhesus (Rh) factor. Low levels of iron in the blood could mean that you have anemia, which can complicate pregnancy. Low iron levels can be treated with dietary changes and sometimes supplements. Certain infections such as HIV, syphilis, or hepatitis B are very serious and can affect the well-being of both mother and baby. Early diagnosis and treatment of these diseases can greatly improve the outcome of the pregnancy. The presence of a type of protein called Rh factor is also tested, because of the possibility of an incompatibility between the mother and baby’s Rh blood groups. If there is Rh incompatibility, it can be treated with an injection of Rh immunoglobulin during pregnancy and shortly after childbirth. Women and their partners who are high-risk for certain genetic diseases such as sickle cell anemia, thalassemia, or cystic fibrosis can have a blood test done to see if they carry the traits for those conditions. If they do test positive for any of these traits, they can be referred to a genetic counsellor.

Pap smear (first medical visit)

The Pap smear is done to check for cervical cellular abnormalities. This is a quick and usually painless, but sometimes uncomfortable, test where an instrument called a speculum is inserted into the vagina, and a swab is used to take a few cells from inside and around the cervix. The swab is sent away for investigation to make sure the cells are healthy. Sometimes women spot after the Pap smear when the site where the cells have been scraped off bleeds a bit. The Pap smear cannot harm the baby or cause a miscarriage.

Urine test (every medical visit)

A urine test can be used at the very first medical visit to confirm the pregnancy. At every medical visit, a urine test is done to measure the presence of white blood cells, sugar, and protein. White blood cells may indicate an infection; sugar could be a sign of diabetes; protein is a sign of high blood pressure called pre-eclampsia or a sign of kidney problems. Diagnosis and treatment of these conditions can help to improve the health of both mother and baby.

Ultrasound (weeks 16 to 20)

Ultrasound uses sound waves to scan the unborn baby in the uterus, and shows a video of the baby onscreen. For most couples, having an ultrasound done is very exciting because they are able to see their baby’s image, albeit a bit fuzzy, for the first time. Ultrasound is used to determine the age of the unborn baby, monitor the beating heart, and check for abnormalities of the head and spine. This technique can also confirm the presence of twins and pinpoint the exact position of the placenta.

Ultrasound is usually done just once during pregnancy, between weeks 16 and 20, but sometimes it is also done late in pregnancy to make sure that the baby is growing properly. Ultrasound can be done regularly throughout the pregnancy if needed.

Gestational diabetes test (weeks 24 to 28)

It is recommended that all pregnant women be screened for gestational diabetes between weeks 24 and 28 of pregnancy. If your health care provider determines that you are high-risk for gestational diabetes, he may request the test as early as 13 weeks. In the screening test, you will be asked to drink a special high-sugar drink, and one hour later, some blood will be drawn and tested. If the screen is borderline positive for gestational diabetes, you will be asked to do an oral glucose tolerance test to confirm the condition. The oral glucose tolerance test involves fasting for four to eight hours, after which time your blood sugar will be measured. You will then be given a sugar drink and your blood sugar will be checked again two hours later. If you test positive for gestational diabetes, you will need to see an endocrinologist to help manage the disease during your pregnancy.

Streptococcus B test (weeks 35 to 37)

Group B streptococcus infections are the most common cause of life-threatening infections in newborn babies. Some doctors choose to test all pregnant mothers in their care between their 35th and 37th week of pregnancy. Any pregnant mothers who test postive for group B streptococcus are then given antibiotics when labour starts. Other doctors do not routinely test all pregnant mothers, but instead treat only those mothers who are at high risk for group B streptococcus.

The group B streptococcus test is simple and painless. The doctor will do a swab of the vagina and rectum to check for the presence of the bacteria. If the test result is positive, the woman will need to receive preventive treatment, called prophylaxis during labour. Prophylaxis treatment involves giving the woman an antibiotic during childbirth. If a mother is high risk for group B streptococcus and either was not tested or the test results have not come back, she should be treated with antibiotics.

After birth, the baby will be monitored for signs of infection and treated with antibiotics if needed.

Screening tests

A number of tests are offered to pregnant women when there is a risk or suspicion that the baby may not be developing properly. Some of these tests are screening tests, meaning that they estimate the risk of a certain abnormality developing. The following is a list of screening tests that may be offered in pregnancy.

Nuchal translucency measurement test (10 to 14 weeks)

Some mothers, for example, those over 35 years of age, are at risk of having a baby with a chromosomal disorder such as Down syndrome. In these cases, a nuchal translucency measurement test can be given in weeks 10 to 14 of pregnancy to help estimate the risk that the baby has Down syndrome. This test uses ultrasound to measure the amount of fluid that has accumulated at the back of the fetus’ neck, between the skin and the underlying structures. When a fetus has a chromosomal disorder, the amount of fluid at the back of the fetus’ neck tends to be increased. If this screening test shows a high risk of Down syndrome, it can be followed by a diagnostic test such as chorionic villus sampling within the first three months of pregnancy, ideally at 10 to 12 weeks gestation, or amniocentesis after week 16.

First trimester combined screening (weeks 11 to 13) followed by alpha-fetoprotein assay (week 16)

First trimester combined screening (FTS) is done in weeks 11 to 13 and consists of a combination of the nuchal translucency ultrasound and a blood test, usually done on the same day. FTS is done to estimate the chances of having a chromosomal abnormality such as Down syndrome. FTS is followed by a blood test called alpha-fetoprotein (AFP) assay in week 16. This test checks the level of AFP in the blood. AFPis a substance produced by the unborn baby’s nervous system tissue. High levels of this protein could mean that the baby may have spina bifida. However, it could also mean that the pregnancy is farther along than originally thought or that the mother is carrying twins. A low level of AFP could mean that the baby has Down syndrome or simply that the pregnancy is not as far along as originally thought. Because this is a screening test, any abnormal results will be followed by a diagnostic test such as amniocentesis.

Integrated prenatal screening (weeks 11 to 13 and again at weeks 15 to 20)

This is similar to FTS followed by AFP. Integrated prenatal screening is a combination of ultrasound, nuchal translucency measurement, and two blood tests to determine your risk of having a baby with a chromosomal abnormality or neural tube defect. The ultrasound is usually done between weeks 11 to 13 of pregnancy. The first blood test is also done between weeks 11 to 13, after the ultrasound. The second blood test is done between weeks 15 to 20, the earlier the better. About four of 100 women have a “positive” result on the integrated prenatal screening. This means that the chance of having a baby with a chromosomal abnormality or neural tube defect is higher than normal. However, most women with a positive result do not have a baby with any of these conditions. If you do have a positive result, you may choose to do a diagnostic test such as amniocentesis to determine if the baby really has one of these conditions. You may also be referred to a genetic counsellor.

Diagnostic tests

A number of tests are offered to pregnant women when there is a risk or suspicion that the baby may not be developing properly. Diagnostic tests are used to confirm the presence of a particular abnormality. The following is a list of diagnostic tests that may be offered in pregnancy.

Chorionic villus sampling (weeks 10 to 12)

Women who are at risk of having a baby with Down syndrome or other chromosomal abnormalities can have a diagnostic test called chorionic villus sampling to confirm the condition. The test is done within the first three months of pregnancy, ideally at 10 to 12 weeks gestation. Chorionic villus sampling involves the insertion of a fine tube through the cervix or abdomen into the uterus. Cells from the tissues surrounding the unborn baby can be removed and tested. Chorionic villus sampling can be done earlier in pregnancy than amniocentesis, and therefore a therapeutic abortion can be done earlier and more safely if necessary. However, there is a slightly higher risk of miscarriage with chorionic villus sampling compared with amniocentesis.

Amniocentesis (after week 16)

If a woman has an abnormal result on a screening test, she may be offered an amniocentesis. Amniocentesis is also offered to women over 35 because of their increased risk of having a baby with Down syndrome. An amniocentesis tests for abnormal chromosomes. In this procedure, a hollow needle is inserted through the abdomen into the uterus. Some amniotic fluid is drawn out and sent for testing. Women who choose to undergo amniocentesis should note that there is an increased risk of miscarriage with this test.

Fetoscopy (after week 16)

In this test, small incisions are made in the mother’s abdomen and uterus, through which a tiny, telescope-like instrument is inserted into the amniotic sac. Fetoscopy is used to view, photograph, and take blood and tissue samples from the unborn baby. Fetoscopy is capable of detecting certain blood and skin diseases that amniocentesis cannot. However, fetoscopy poses a higher risk to the unborn baby than other techniques, and therefore it is not used very often.

Cordocentesis (after week 18)

Women at high risk may be offered this test to confirm a chromosomal abnormality. In cordocentesis, a hollow needle is inserted through the mother’s abdomen into the blood vessels of the umbilical cord, close to the placenta. A sample of the baby’s blood is withdrawn. Because the baby’s blood vessels need to be large enough for the needle to be properly inserted, this procedure is only done after week 18 of pregnancy.

Fetal echocardiography (18 weeks)

Some women are at higher risk of having a baby with a heart defect. Fetal echocardiography is a procedure that uses ultrasound waves to study the heart of the unborn baby in great detail and to diagnose heart defects. When heart defects are diagnosed before birth, faster medical intervention can be put in place when the baby is born, which improves the baby’s chances of survival after birth.
Tests in late pregnancy

Non-stress test

These tests are commonly used in late pregnancy to monitor how the baby is doing. A non-stress test might be used if the pregnancy is overdue, or if there are other potential complications in late pregnancy. In this test, the mother is hooked up to a fetal monitor, and the variation of the unborn baby’s heart to certain movements is observed. If there are abnormalities in the heart’s response to movement, it may indicate that the baby is in distress.

Biophysical profile

If your pregnancy is overdue or there are other potential complications, your doctor may want you to have a biophysical profile done. This involves both a nonstress test with electronic fetal heart monitoring and an ultrasound to measure the following five factors: your baby's heart rate, muscle tone, movement, breathing, and the amount of amniotic fluid. The results are scores from 0 to 2 points on each of these five measurements in a 30-minute observation period. A total score of 8 to 10 points indicates a healthy baby. A score of 6 to 8 points means you will need to be retested. A score of 4 or less may mean the baby is having problems.

Friday, March 26, 2010

Gestational Diabetes

Gestational diabetes is a kind of diabetes that comes on during pregnancy. It affects about 4% of all pregnant women, according to the American Diabetes Association. Gestational diabetes is often diagnosed on screening tests done between weeks 24 and 28 of pregnancy.

While doctors aren't sure what causes gestational diabetes, it is believed that hormones from the placenta may block the action of insulin in the mother. This means that the mother needs more insulin and sometimes her pancreas cannot make enough to transport the sugar in the blood into the cells for energy. The mother's blood has high levels of glucose, which can cross the placenta, giving the growing baby a high blood sugar level.

In response, the baby's pancreas starts making extra insulin to transport the sugar into the cells to be used for energy. When the pancreas can't keep up, the extra blood sugar is stored as fat on the baby, and that can lead to health problems for the unborn baby. Infants of diabetic mothers are at risk for abnormal growth, premature delivery, and breathing problems, among other things.

If your doctor diagnoses you with gestational diabetes, it's likely that you'll be started on a treatment plan aimed at getting glucose levels under control. This includes a plan to manage your nutrition, physical activity, and weight gain.

While most diabetes diagnosed during pregnancy resolves after delivery, some women will have gestational diabetes during future pregnancies and some may be more likely to develop diabetes as they get older.

And some women who are diagnosed while pregnant may actually have been diabetic before the pregnancy. In these cases, the diabetes does not disappear after delivery.

Thursday, March 25, 2010

Week Fourteen

Your Baby's Development

By this week, some fine hairs have developed on your baby’s face. This soft colorless hair is called lanugo, and it will eventually cover most of your baby’s body until it is shed just before delivery.

By now, your baby’s genitals have fully developed, though they may still be difficult to detect on an ultrasound examination. In addition, your baby starts to produce thyroid hormones because the thyroid gland has matured. Your baby now weighs about 1.6 ounces (45 grams) and is about 3.5 inches (9 cm) long from crown to rump.

Your Body

Under certain circumstances (for example, if you're older than 35), your health care provider may discuss amniocentesis with you. Amniocentesis is a test usually done between 15 and 18 weeks that can detect abnormalities in a fetus, such as Down syndrome. During this test, a very thin needle is inserted into the amniotic fluid surrounding the baby in the uterus and a sample of the fluid is taken and analyzed. Amniocentesis does carry a very slight risk of miscarriage, so talk to your health care provider about your concerns and the risks and advantages of the test.

Wednesday, March 24, 2010

Safe Cleaning During Pregnancy

Wondering how best to tackle your dirty house ... while pregnant? If you have the energy to grab a dust cloth or suddenly feel compelled to clean the bathroom, be sure to check out these tips to ensure that you clean safely. Many common cleaning products are not safe during pregnancy. Here's what you need to know!

1. Make sure that you have good ventilation where you are cleaning.

2. Wear protective gloves and clothing to protect your skin.

3. Always read the warning and instruction labels.

4. Never mix different chemicals because they may create poisonous fumes (as do ammonia and bleach).

5. Avoid cleaning the oven since it is such a tight space and the ventilation is not good.

Now that we've gotten the ground rules out of the way, check out the following pregnancy-safe cleaning tips!

Read the Warning Label... carefully!

While overexposure to any chemical is a bad idea, there are a few that come with a skull and crossbones on the label for a reason … they're extraordinarily dangerous to handle. Read the manufacturer's safety warnings before using any cleaning product. (Oven and drain cleaners are particularly toxic substances.)

If it's necessary to use these chemicals, play it safe by having your spouse or a friend handle them. Always ensure the room is well ventilated and don't return to a recently cleaned bathroom or kitchen until the chemicals have dissipated.

When the giant "TOXIC" warning label makes you hesitate, try a natural alternative like creating a paste of soap, water, and baking soda to scrub the oven. (You can add salt to the paste for a little extra abrasive power.)

Steer Clear of Paint

If you're overwhelmed by that all-powerful nesting instinct and can't wait to decorate the new nursery, stick to picking colors, but be sure to stay away from the paint itself. If you're working on an older home, you run the risk of coming into contact with paint chips containing lead. Prenatal exposure to lead can cause premature birth and lead to smaller stature and impaired mental development in babies. For less than 10 dollars you can purchase a lead test kit from a hardware store or over the Internet, making a lead test a small investment in peace of mind.

Even though paints purchased today are lead-free, some contain chemicals believed to be harmful to a growing fetus. As a result, most doctors recommend that pregnant women leave the painting to someone else.

Too Much of a Good Thing Is Dangerous

Antibacterial hand sanitizers and cleaning products have been the rage for the last few years, and the trend shows no sign of slowing down. Consumers can purchase antibacterial window cleaners, cutting boards, even mattresses coated with antibacterial agents. Yet the Center for Disease Control (CDC) warns that despite our nation's scrupulous sanitation efforts, we haven't reduced disease, we've actually created antibiotic resister superbugs like Staphylococcus aureus.

Even more concerning for parents are the recent studies conducted in America and Europe which indicate that children raised in an "over-clean" environment are more likely to develop asthma, allergies, eczema and other autoimmune disorders. Doctors theorize that a young immune system must be exercised or challenged by exposure to germs in order to mature correctly. Otherwise, it will turn on itself and start reacting to everything!

The bottom line: Use soap and hot water to wash your hands and most of your home. If you must disinfect, try one-quarter cup of chlorine bleach mixed with a gallon of water, but wear rubber gloves and never mix bleach with other cleaning products.

Wear Gloves

You absorb chemicals and toxins not just by breathing. Skin, your body's largest organ, absorbs them, too. So don't forget to don a pair of protective glove before cleaning.

Also, put on some gloves if you're working with your house plants. Toxoplasma gondii (the same bacteria found in your cat's litter) can be found in potting soil, too. And if your partner, friend, or family member is nearby, ask them to help with the cleaning duties!

Stay Grounded

While cleaning the top of the refrigerator or dusting the ceiling fans might not be part of your regular cleaning routine, chances are you've journeyed to the higher reaches of the your home a few times to give them a once over. Unfortunately that top shelf will need to wait to be dusted until after your due date because scaling ladders or balancing on your kitchen counters isn't a great idea when a little baby is along for the adventure.

Pregnant women are not only off balance because of their growing bellies, they're more prone to slips because of loose hip and pelvis ligaments caused by the pregnancy hormone Relaxin. If the high altitude dust can't wait, invest in a telescoping dusting brush, available at home improvement stores, or wrap a damp dishtowel around a mop or broom and do your best from the safety of the floor.

Trust Your Senses

Nature gives pregnant women an amazing, sometimes overactive, sense of smell. And that's a good thing. Scientists theorize that this special sensitivity to odors is a protective mechanism designed to keep expectant women from eating spoiled food in the days before refrigeration. Now we've got expiration dates to solve the bad food problem, but a sharp nose can still be used to us from dangerous substances.

If you're using a public restroom, and detect an unpleasant odor or a scratchy feeling in your throat, leave immediately. Or if an air-freshening spray burns your nose or gives you a headache, stop using it and either delegate the cleaning duties to someone else, or switch to an organic alternative (like simmering spices to freshen the air).

Homemade Cleaners

What's the best way of knowing exactly what you're spraying on your countertops? Take control of your home environment and make your own cleaners. Books like The Naturally Clean Home and Clean and Green contain recipes for cleaning nearly every surface of your home using basic ingredients like lemon juice, vinegar, and citrus oil.

The Internet itself is full of helpful websites listing non-toxic home cleaning recipes along with testimonials from users. Consider this recipe for an all-purpose cleaner:

2 Tbs Vinegar
1 Tsp Borax
Hot water
A few drops of a mild dish detergent
10 drops of essential oil (optional)

Put ingredients in spray bottle, fill with hot water, and swish to mix.

Go Green

Homemade house cleaners not only keep you and your baby safe from harsh chemical and toxins, they cost quite a bit less than commercially produced cleaners, leaving mommy a little extra money for important things like oodles of baby gear! In fact, many natural cleaners can be made from items from your pantry. Just open fridge and mix up a batch of this furniture polish recipe recommended by Sara Noel and posted on naturalfamilyonline.com.

1 cup vegetable or olive oil
½ cup lemon juice

Combine in a spray bottle mix, shake well and apply a small amount to a cloth.

Spray In, Not Out

If homemade cleaners aren't your cup of tea or you just love the way your favorite cleaning product works, try to reduce the amount of chemicals you inhale by spraying them directly into a cleaning cloth, sponge, or paper towel (just remember to wear gloves and work in a ventilated area).

A bit of orange oil dabbed onto a cloth is enough to dust a whole room, so there's no need to spray aerosol furniture polish across the tops of the tables. To brighten up the kitchen or bath, pour some all-purpose cleaner in a bucket, add water, don your gloves, and dip a sponge in the bucket, rather than spraying the cleaner everywhere. And while it takes a bit more time, just squirt a bit of window cleaner into a paper towel, then wipe them down. When it comes to chemicals in the air, less is more.

Tuesday, March 23, 2010

Week Thirteen

Your Baby's Development

As you begin the second trimester of pregnancy, your placenta has developed and is providing your baby with oxygen, nutrients, and waste disposal. The placenta also produces the hormones progesterone and estrogen, which help to maintain the pregnancy.

By now, the baby's eyelids have fused together to protect the eyes as they develop. Once you take your newborn home, you might be wishing for those eyes to close once in a while so you can get some rest!

Your baby may also be able to put a thumb in his or her mouth this week, although the sucking muscles aren't completely developed yet.

Your Body

At your first prenatal appointment, your health care provider probably gave you a prescription for prenatal vitamins. Taking these supplements, in addition to eating a healthy diet, ensures your baby gets additional vitamins and minerals, such as folic acid, zinc, iron, and calcium, which are necessary for growth and development. Talk to your pharmacist about the best way to take your vitamins, such as whether they should be taken with food or beverages.

Monday, March 22, 2010

Sex During Pregnancy

If you're pregnant or even planning a pregnancy, you've probably found an abundance of information about sex before pregnancy (that is, having sex in order to conceive) and sex after childbirth (general consensus: expect a less active sex life when there's a newborn in the house).

But there's less talk about the topic of sex during pregnancy, perhaps because of our culture's tendency to dissociate expectant mothers from sexuality. Like many parents-to-be, you may have questions about the safety of sex and what's normal for most couples.

Well, what's normal tends to vary widely, but you can count on the fact that there will be changes in your sex life. Open communication will be the key to a satisfying and safe sexual relationship during pregnancy.

Is It Safe to Have Sex During Pregnancy?

If you're having a normal pregnancy, sex is considered safe during all stages of the pregnancy.

So what's a "normal pregnancy"? It's one that's considered low-risk for complications such as miscarriage or pre-term labor. Talk to your doctor, nurse-midwife, or other pregnancy health care provider if you're uncertain about whether you fall into this category. (The next section of this article may help, too.)

Of course, just because sex is safe during pregnancy doesn't mean you'll necessarily want to have it! Many expectant mothers find that their desire for sex fluctuates during certain stages in the pregnancy. Also, many women find that sex becomes uncomfortable as their bodies get larger.

You and your partner need to keep the lines of communication open regarding your sexual relationship. Talk about other ways to satisfy your need for intimacy, such as kissing, caressing, and holding each other. You also may need to experiment with other positions for sex to find those that are the most comfortable.

Many women find that they lose their desire and motivation for sex late in the pregnancy - not only because of their size but also because they're preoccupied with the impending delivery and the excitement of becoming a new parent.

When It's Not Safe

There are two types of sexual behavior that aren't safe for any pregnant woman:

* If you engage in oral sex, your partner should not blow air into your vagina. Blowing air can cause an air embolism (a blockage of a blood vessel by an air bubble), which can be potentially fatal for mother and child.

* You should not have sex with a partner whose sexual history is unknown to you or who may have a sexually transmitted disease, such as herpes, genital warts, chlamydia, or HIV. If you become infected, the disease may be transmitted to your baby, with potentially dangerous consequences.

If your doctor, nurse-midwife, or other pregnancy health care provider anticipates or detects certain significant complications with your pregnancy, he or she is likely to advise against sexual intercourse. The most common risk factors include:

* a history or threat of miscarriage

* a history of pre-term labor (you've previously delivered a baby before 37 weeks) or signs indicating the risk of pre-term labor (such as premature uterine contractions)

* unexplained vaginal bleeding, discharge, or cramping

* leakage of amniotic fluid (the fluid that surrounds the baby)

* placenta previa, a condition in which the placenta (the blood-rich structure that nourishes the baby) is situated down so low that it covers the cervix (the opening of the uterus)

* incompetent cervix, a condition in which the cervix is weakened and dilates (opens) prematurely, raising the risk for miscarriage or premature delivery

* multiple fetuses (you're having twins, triplets, etc.)

Common Questions and Concerns

The following are some of the most frequently asked questions about sex during pregnancy.

Can sex harm my baby?

No, not directly. Your baby is fully protected by the amniotic sac (a thin-walled bag that holds the fetus and surrounding fluid) and the strong muscles of the uterus. There's also a thick mucus plug that seals the cervix and helps guard against infection. The penis does not come into contact with the fetus during sex.

Can intercourse or orgasm cause miscarriage or contractions?

In cases of normal, low-risk pregnancies, the answer is no. The contractions that you may feel during and just after orgasm are entirely different from the contractions associated with labor. However, you should check with your health care provider to make sure that your pregnancy falls into the low-risk category. Some doctors recommend that all women stop having sex during the final weeks of pregnancy, just as a safety precaution, because semen contains a chemical that may actually stimulate contractions. Check with your health care provider to see what he or she thinks is best.

Is it normal for my sex drive to increase or decrease during pregnancy?

Actually, both of these possibilities are normal (and so is everything in between). Many pregnant women find that symptoms such as fatigue, nausea, breast tenderness, and the increased need to urinate make sex too bothersome, especially during the first trimester. Generally, fatigue and nausea subside during the second trimester, and some women find that their desire for sex increases. Also, some women find that freedom from worries about contraception, combined with a renewed sense of closeness with their partner, makes sex more fulfilling. Desire generally subsides again during the third trimester as the uterus grows even larger and the reality of what's about to happen sets in.

Your partner's desire for sex is likely to increase or decrease as well. Some men feel even closer to their pregnant partner and enjoy the changes in their bodies. Others may experience decreased desire because of anxiety about the burdens of parenthood, or because of concerns about the health of both the mother and their unborn child.

Your partner may have trouble reconciling your identity as a sexual partner with your new (and increasingly visible) identity as an expectant mother. Again, remember that communication with your partner can be a great help in dealing with these issues.

When to Call Your Doctor

Call your health care provider if you're unsure whether sex is safe for you. Also, call if you notice any unusual symptoms after intercourse, such as pain, bleeding, or discharge, or if you experience contractions that seem to continue after sex.

Remember, "normal" is a relative term when it comes to sex during pregnancy. You and your partner need to discuss what feels right for both of you.

Friday, March 19, 2010

Birthing Classes

If you are having a child for the first time, it is easy to feel overwhelmed by questions, fears, and just not knowing what to expect. Many new parents find that birthing classes can really help calm their worries and answer many questions.

These classes cover all kinds of issues surrounding childbirth including breathing techniques, pain management, vaginal birth, and cesarean birth. They can help prepare you for many aspects of childbirth: for the changes that pregnancy brings, for labor and delivery, and for parenting once your baby is born.

Typically, new parents take birthing classes during the third trimester of the pregnancy, when the mother is about 7 months pregnant. But there are a variety of different classes which begin both sooner and later than that. It's a good idea to talk with your doctor about the different kinds of classes that are offered in your community.

Benefits of Taking a Childbirth Class

A childbirth class can provide you with a great forum to ask lots of questions and can help you make informed decisions about key issues surrounding your baby's birth. Some of the information you can find out from a birthing class includes:

* how your baby is developing
* healthy developments in your pregnancy
* warning signs that something is wrong
* how to make your pregnancy, labor, and delivery more comfortable
* breathing and relaxation techniques
* how to write a birth plan
* how to tell when you are in labor
* pain relief options during labor
* what to expect during labor and delivery
* the role of the coach or labor partner

Many classes also address what to expect after the baby is born, including breastfeeding, baby care, and dealing with the emotional changes of new parenthood.

You might also find support from other expectant couples at a childbirth class. Who would better understand the ups and downs of pregnancy than couples who are going through them, too? Many people find friends in their childbirth class who last long past the birth of their child.

If your birth coach is also the baby's father, taking a class together can mean his increased involvement in the pregnancy, and can act as a good bonding experience. Like the mother, the father can also benefit from knowing what to expect when the mother goes into labor - and how to assist in that process. Some classes have one session just for fathers, where men can discuss their own concerns about pregnancy and birth. There are also classes geared just for new fathers. Some classes even offer a special session for new grandparents, which is a great way to get them involved in the process and to make sure they're up on the latest in baby care techniques and safety.

Of course, some people get more out of childbirth classes than others do. But even if you find the techniques you're taught don't work for you when you finally go into labor, you may get other benefits from the class. The common goal of all birthing classes is to provide you with the knowledge and confidence you need to give birth and make informed decisions. This includes reducing your anxiety about the birth experience, as well as providing you with a variety of coping techniques to aid in pain management. Remember that the ultimate goal is to have a healthy mom and healthy baby.

What Types of Classes Are Available?

Many childbirth classes embrace a particular philosophy about pregnancy and birth. The two most common methods of childbirth breathing, relaxation, and exercise in the United States are the Lamaze technique and the Bradley method.

The Lamaze technique is the most widely used method in the United States. The Lamaze philosophy holds that birth is a normal, natural, and healthy process and that women should be empowered through education and support to approach it with confidence. The goal of Lamaze is to explore all the ways women can find strength and comfort during labor and birth. Classes focus on relaxation techniques, but they also encourage the mother to condition her response to pain through training and preparation (this is called psychoprophylaxis). This conditioning is meant to teach expectant mothers constructive responses to the pain and stress of labor (for example, controlled breathing patterns) as opposed to counterproductive responses (such as holding the breath or tensing up). Other techniques, such as distraction (a woman might be encouraged to focus on a special object from home or a photo, for example) or massage by a supportive coach, are also used to decrease a woman's perception of pain.

Lamaze courses don't advocate for or against the use of drugs and routine medical interventions during labor and delivery, but instead educate mothers about their options so they can make informed decisions when the time comes.

The Bradley method (also called "Husband-Coached Birth") places an emphasis on a natural approach to birth and on the active participation of the baby's father as the birth coach. A major goal of this method is the avoidance of medications unless absolutely necessary.

Other topics stressed include the importance of good nutrition and exercise during pregnancy, relaxation techniques (such as deep breathing and concentration on body signals) as a method of coping with labor, and the empowerment of parents to trust their instincts and become active, informed participants in the birth process. The course is traditionally offered in 12 sessions.

Although Bradley emphasizes a birth experience without pain medication, the classes do prepare parents for unexpected complications or situations, like emergency cesarean sections. After the birth, immediate breast-feeding and constant contact between parents and baby is stressed. Bradley is the method of choice for many women who give birth at home or in other nonhospital settings.

There are several other types of birthing classes available. Some include information from the two previously mentioned techniques, and some are offshoots that explore one particular area. Two options that might be available in your area are active birth classes that teach yoga techniques to prepare for labor and "hypnobirthing" courses, which use deep relaxation and self-hypnosis as relaxation techniques.

When Should I Start Taking a Class?

In addition to offering many techniques and curricula, birthing classes also vary greatly in terms of duration. You'll find classes that begin during the first trimester and focus on all the changes that pregnancy brings; 5- to 8-week courses offered late in pregnancy aimed at educating parents mostly about labor, delivery, and postpartum issues; and one-time-only refresher courses for repeat parents. Most parents opt for a course that meets about six or seven times in the last trimester for 1 1/2 to 2 hours per session, or for full-day versions that take place over one or two weekends. What's important to remember is that a variety of options are often offered, so be sure and find one that fits your needs.

Choosing a Class

The type of class that's right for you depends on your personality and beliefs, as well as those of your labor partner. There is no one correct method. If you're the kind of person who likes to share and is eager to meet people, you might like a smaller, more intimate class designed for couples to swap stories and support each other. If you don't like the idea of sharing in a small group, you might want a larger class, where the teacher does most of the talking.

Of course, the community you live in may limit your choices - expectant parents in rural areas often have fewer choices than those in large cities. You may find childbirth classes offered by:

* hospitals
* private teachers
* health care providers (through their practices)
* community health organizations
* midwives
* national childbirth education organizations
* videos and DVDs

Before you sign up for a class, it's a good idea to ask what the curriculum includes and what philosophy it is based upon. You can also request to see the course outline. A good class will cover a range of topics and prepare you for the many possible scenarios of labor and delivery. Classes should include information about vaginal births and cesarean sections; natural childbirth techniques as well as the use of pain medication during labor; tips on pre- and postnatal care; and postpartum adjustment.

If something you wanted or expected to see isn't included in the outline, ask about it - if your teacher doesn't seem flexible or his or her philosophy doesn't match yours, you may want to look elsewhere.

You should also feel free to contact the teacher or childbirth class coordinator with questions, such as:

* What's your background and how were you trained?
* Do you have certification from a nationally recognized organization?
* What is your philosophy? Do you teach a particular method?
* How does the class time break down between lecture, discussion, and practicing techniques?
* How many people are in the class?

Whatever course or method you choose, you'll want to begin exploring your options early - some classes fill up well in advance of the start date.

Thursday, March 18, 2010

Week Twelve

Your Baby's Development

Your baby's brain continues to develop, and tiny fingernails and toenails start to form. Vocal cords are formed this week, which is the last of your first trimester.

Your baby's kidneys are functioning! After swallowing amniotic fluid, your baby will now be able to pass it out of the body as urine. And the intestines will make their way into the abdomen, since there is room for them now.

Your Body

Has anyone told you that you have that "pregnant glow"? It's not just the joy you may feel because you're having a baby — there's a physiological reason for smoother, more radiant skin during pregnancy. Increased blood volume and pregnancy hormones work together to give you that glow. The greater blood volume brings more blood to the blood vessels and hormones increase oil gland secretion, resulting in a flushed, plumper, smoother skin appearance. Sometimes, though, the increased oil gland secretion can cause temporary acne.

Wednesday, March 17, 2010

Birthing Centers and Hospital Maternity Services

You'll make plenty of decisions during pregnancy, and choosing where to give birth — whether in a hospital or in a birth center setting — is one of the most important.


Many women fear that a hospital setting will be cold and clinical, but that's not necessarily true. A hospital setting can accommodate a variety of birth experiences.

Traditional hospital births (in which the mother-to-be moves from a labor room to a delivery room and then, after the birth, to a semiprivate room) are still the most common option. Doctors "manage" the delivery with their patients. In many cases, women in labor are not allowed to eat or drink (possibly due to anesthesia or for other medical reasons), and they may be required to deliver in a certain position.

Pain medications are available during labor and delivery (if the woman chooses); labor may be induced, if necessary; and the fetus is usually electronically monitored throughout the labor. A birth plan can help a woman communicate her preferences about these issues, and doctors will abide by these as much possible.

In response to a push for more "natural" birth events, many hospitals now offer more modern options for low-risk births, often known as family-centered care. These may include private rooms with baths (birthing suites) where women can labor, deliver, and recover in one place without having to be moved.

Although a doctor and medical staff are still present, the rooms are usually set up to create a nurturing environment, with warm, soothing colors and features that try to simulate a home-like atmosphere that can be very comforting for new moms. Rooming in — when the baby stays with the mother most of the time instead of in the infant nursery — also may be available.

In addition, many hospitals offer a variety of childbirth and prenatal education classes to prepare parents for the birth experience and parenting classes after birth.

The number of people allowed to attend the birth varies from hospital to hospital. In more traditional settings, as many as three support people are permitted to be with the mother during a vaginal birth. In a family-centered approach, more family members, friends, and sometimes even kids may be allowed. During a routine or nonemergency C-section, usually just one support person allowed.

If you decide to give birth in a hospital, you will encounter a variety of health professionals:

Obstetrician/gynecologists (OB/GYNs) are doctors with at least 4 additional years of training after medical school in women's health and reproduction, including both surgical and medical care. They can handle complicated pregnancies and also perform C-sections.

Look for obstetricians who are board-certified, meaning they have passed an examination by the American Board of Obstetrics and Gynecology (ACOG). Board-certified obstetricians who go on to receive further training in high-risk pregnancies are called maternal-fetal specialists or perinatologists.

If you deliver in a hospital, you also might be able to use a certified nurse-midwife (CNM). CNMs are registered nurses who have a graduate degree in midwifery, meaning they're trained to handle normal, low-risk pregnancies and deliveries. Most CNMs deliver babies in hospitals or birth centers, although some do home births.

In addition to obstetricians and CNMs, registered nurses (RNs) attend births to take care of the mother and baby. If you give birth in a teaching hospital, medical students or residents might be present during the birth. Some family doctors also offer prenatal care and deliver babies.

While you're in the hospital, if you choose or if it's necessary for you to receive anesthesia, it will be administered by a trained anesthesiologist. A variety of pain-control measures, including pain medication and local, epidural, and general anesthesia, are available in the hospital setting.

Birth Centers

Women who experience delivery in a birth center are usually those who have already given birth without any problems and whose current pregnancies are considered low risk (meaning they are in good health and are the least likely to develop complications).

Women giving birth to multiples, have certain medical conditions (such as gestational diabetes or high blood pressure), or whose baby is in the breech position are considered higher risk and should not deliver in a birth center. Women are carefully screened early in pregnancy and given prenatal care at the birth center to monitor their health throughout their pregnancy.

Natural childbirth is the focus in a birth center. Since epidural anesthesia usually isn't offered, women are free to move around in labor, get in the positions most comfortable to them, spend time in the jacuzzi, etc. The baby is monitored frequently in labor typically with a handheld Doppler. Comfort measures such as hydrotherapy, massage, warm and cold compresses, and visualization and relaxation techniques are often used. The woman is free to eat and drink as she chooses.

A variety of health care professionals operate in the birth center setting. A birth center may employ registered nurses, CNMs, and doulas (professionally trained providers of labor support and/or postpartum care). Although a doctor is seldom present and medical interventions are rarely done, birth centers may work with a variety of obstetric and pediatric consultants. The professionals affiliated with a birth center work closely together as a team, with the nurse-midwives present and the OB/GYN consultants available if a woman develops a complication during pregnancy or labor that puts her into a higher risk category.

Birth centers do have medical equipment available, including intravenous (IV) lines and fluids, oxygen for the mother and the infant, infant resuscitators, infant warmers, local anesthesia to repair tears and episiotomies (although these are seldom performed), and oxytocin to control postpartum bleeding.

A birth center can provide natural pain control and pain control with mild narcotic medications, but if a woman decides she wants an epidural, or if complications develop, she must be taken to a hospital.

Birth centers often provide a homey birth experience for the mother, baby, and extended family. In most cases, birth centers are freestanding buildings, although they may be attached to a hospital. Birth centers may be located in residential areas and generally include amenities such as private rooms with soft lighting, showers, and whirlpool tubs. A kitchen may be available for the family to use.

Look for a birth center that is accredited by the Commission for the Accreditation of Birth Centers (CABC). Some states regulate birth centers, so find out if the birth center you choose has all the proper credentials.

Tuesday, March 16, 2010

Week Eleven

Your Baby's Development

From this week until week 20, your baby will be growing rapidly — increasing in size from about 2 inches (5 cm) to about 8 inches (20 cm) from crown to rump. To accommodate all this growth, the blood vessels in the placenta are increasing in both size and number to provide the baby with more nutrients.

Facial development continues as the ears move toward their final position on the sides of the head. If you saw a picture of your baby now, you'd think you had a genius on your hands — the baby's head accounts for about half of the body length!

Although your baby's reproductive organs are developing rapidly, the external genitals of boys and girls appear somewhat similar until the end of week 11. They will be clearly differentiated by week 14.

Your Body

Nourishing your baby usually requires that you gain weight — and in most cases, the recommended weight gain is 25 to 35 pounds (11.33 to 15.87 kg) over the course of the pregnancy. If you were overweight or underweight before pregnancy, your health care provider may have different recommendations for weight gain.

Monday, March 15, 2010

Pregnancy Weight Gain

Clearly, it is quite obvious that you will be experiencing a pregnancy weight gain. After all, there is a person growing inside you. However, what surprises some women is that the average baby weighs around three to four kilograms, yet our pregnancy weight gain is more often between nine and fourteen kilograms. Why is this?

The main reason is that there is more to pregnancy weight gain than simply the weight of the baby. You also need to consider the weight of the placenta, amniotic fluids and membranes. Consider also your water retention, the increase in size of your breasts and the additional blood movements of your body. As you can see, there are a lot of different things the affect pregnancy weight gain. The good news is, you will quickly return to normal after the birth.

It is impossible to say exactly how much of a pregnancy weight gain you should experience; it will be a different amount for different women. For example an underweight person will put on more weight in proportion to their original weight, than an over weight person. Generally, if you can enjoy a mind set of "I'm pregnant, therefore I do not care about my weight", you are more inclined to have a much more enjoyable pregnancy.

One thing is certain; it is dangerous to fight the weight gain. You should not try to remain slim during pregnancy. A pregnancy weight gain is paramount to the health of you and your baby, fighting the weight gain could prove very hazardous to your unborn baby.

If you are worried about the extra weight you are putting on and whether it will come off after the birth of your baby, you're generally worrying without reason. However, if this is the type of thing that keeps you awake at night, it's probably best to address you worries as soon as possible. One way of doing this is to measure the area around your upper thighs once a week; the upper thigh measurement should stay roughly the same throughout the pregnancy, although it can increase dramatically during the last few weeks.

If you do have any pregnancy weight gain concerns the best people to speak with are your midwife and doctor. If they think it is necessary, they will refer you to a nutritionist.

The table below is a guide to the pregnancy weight gain proportions you should expect.

Weight of baby - 39%

Weight of placenta - 10%

Amniotic fluid - 12%

Increase in weight of breast and uterus - 19%

Increase in the weight of blood - 022%

We've also included this table below which shows a pregnancy weight gain guide and which months to expect to put on weight.

Conception to 12 weeks - 0% weight increase

12 - 20 weeks - 25% weight increase

20 - 30 weeks - 50% weight increase

30 - 36 weeks - 25% weight increase

36 - 40 weeks - 0% weight increase

Obviously, it is important to mention that the table above is a guide. For some women it will be different, they will experience pregnancy weight gain right up to the day of birth.

Thursday, March 11, 2010

Week Ten

Your Baby's Development

By week 10, all of your baby's vital organs have been formed and are starting to work together.

As external changes such as the separation of fingers and toes and the disappearance of the tail takes place, internal developments are taking place too. Tooth buds form inside the mouth, and if you're having a boy, his testes will begin producing the male hormone testosterone.

Congenital abnormalities are unlikely to develop after week 10. This also marks the end of the embryonic period — in general, the embryo now has a distinctly human appearance and starting next week your baby will officially be considered a fetus.

Your Body

Your first prenatal visit, which often takes place around this time, is a milestone. At the doctor's office, you'll go through a series of tests and checks, including having your weight and blood pressure checked. You might also have an external abdominal examination to check the size and position of your baby and have your urine tested. During this first prenatal visit, your health care provider will thoroughly examine you, including an internal examination and a breast exam. Your health care provider will also ask you many questions about your medical history and any family health problems, to determine if your baby is at risk for genetic diseases. Another thing your provider will check? Your baby's heartbeat! Using a Doppler stethoscope, you should get to hear it for the first time.

As you leave your first appointment, your health care provider will probably send you for a blood test to find out whether you are immunized against varicella, measles, mumps, and rubella (German measles), as well as to determine your blood type and Rh factor.

Wednesday, March 10, 2010

Newborn Essentials Checklist

What you'll need to have on hand for the early days with your newborn


8 undershirts or onesies (mix of short-sleeve and long-sleeve)
5 nightgowns (for use until the cord falls off)
8 one-piece stretchy sleepers (go for ones with zippers; new moms swear by them!)
5 pairs of pants
2 newborn hats
8 pairs of socks or booties, to wear with nightgowns and outfits
2 pairs of scratch mittens, to keep baby from scratching his face
2 cardigans or jackets, more in winter
Bunting bag or snowsuit for winter baby
Laundry detergent for infants
4 outfits for dressing up (optional)


3 large cotton blankets
8 receiving blankets (they also make handy burp cloths)


If you’re breastfeeding, you don’t really need any equipment.

Some nursing mothers like to have these items:

Lots of bibs
Burp cloths
Breast pump
Milk storage containers
Nursing pillow
Nursing bras (if buying before baby is born, buy one cup size larger than your pregnant bra size)
Breast pads (disposable or washable)
Lotion for sore nipples

If you are formula feeding:

Lots of bibs
Burp cloths
8 four-ounce bottles with nipples
6 eight-ounce bottles with nipples
Bottle and nipple brush
Formula (be sure to check expiry date and note the lot number in case of recalls)
Thermal bottle carrier


If you are using re-usable cloth diapers:

Several dozen (4 or 5) cloth or re-usable diapers
8 waterproof covers
1 diaper pail
Changing pad
Baby ointment or other barrier cream to prevent rash
Snaps, Velcro or safety pins to secure re-usable diapers
Disposable wipes or a couple dozen washcloths for cleaning baby’s bottom

If you are using disposable diapers:

Two boxes of newborn-size diapers (it’s better not to buy too many in advance in case your baby is large or grows quickly)
1 diaper pail
Changing pad
Baby ointment or barrier cream to prevent rash
Disposable wipes or a couple dozen washcloths for cleaning baby’s bottom


1 plastic infant tub (or use a large dishpan in the sink, or take baby in the bath with you)
12 washcloths, not used on baby’s bottom
Baby soap or cleanser
Baby shampoo
Baby soft-bristled hair brush
3 soft-hooded towels


If you are using a crib:

Approved crib and crib mattress
3 waterproof mattress covers
4 fitted cribsheets
4 light blankets that fit in the crib

If you are co-sleeping:

Firm mattress (not a waterbed)
3 waterproof pads to place under baby
2 comforters (depending on the season)

Other necessities

Approved infant safety seat for car
Stroller that reclines so newborn can lie flat
Nail clippers or scissors (or just bite off baby’s nails as needed)
Bulb syringe for suctioning mucous
Baby thermometer
Eye dropper or medicine spoon
Medication in case of fever

Nice-to-have items

Change table (or just use change pad on top of dresser or bed)
Rocking chair for feeding and swaddling
Sling or baby carrier
Diaper bag
1 or 2 change pads
Plastic hangers for closet
Sun shade for car windows
2 or 4 pacifiers (if you choose to use these)
Rattles and other baby toys
Night light

Tuesday, March 9, 2010

Week Nine

Your Baby's Development

The tail at the bottom of your baby's spinal cord has shrunk and almost disappeared by this week. In contrast, your baby's head has been growing — it's quite large compared with the rest of the body and it curves onto the chest. By this week, your baby measures about 0.6 to 0.7 inches (16 to 18 millimeters) from crown to rump and weighs around 0.1 ounces (3 grams). The tip of the nose has developed and can be seen in profile, and flaps of skin over the eyes have begun to shape into eyelids, which will become more noticeable in the next few weeks.

The digestive system continues to develop. The anus is forming, and the intestines are growing longer. In addition, internal reproductive features, such as testes and ovaries, start to form this week.

Your baby may make some first movements this week as muscles develop. If you had an ultrasound now, those movements might even be visible, but you won't be able to feel them for several more weeks.

Your Body

In preparation for your first prenatal visit, take the time to familiarize yourself with your family's health history and to review your medical records. Have you had any chronic illnesses, allergies, or surgeries? Are you currently taking any prescription medications? Do you know of any genetic disorders that run in your family? Has your menstrual cycle been regular, and have you had any past pregnancies? Do you smoke or drink alcohol? What are your exercise habits? These are the things your health care provider will want to discuss with you, so it will help to have this information ready when you go.

Monday, March 8, 2010

What Are Midwives and Doulas?

Whether you’re a first-time mom or mom of many, having a baby brings with it many different emotions, perhaps the most common of which is worry. Mom’s worry. If you are expecting, you’re probably pondering the type of delivery you would like to have. Many women are opting for more natural births that can be performed in the home with as little medical intervention as possible.

This trend is becoming increasingly more common for second-time moms, having tried a traditional birth once, are more open to trying something more natural the second time around.

If you are considering a natural birth, you will undoubtedly want to know more about midwifery and doula practices. As a midwife or doula will tell you, there are many differences between a traditional or medically-managed birth versus a natural childbirth either at home or in the hospital.


A midwife may deliver your baby in your home or in a hospital. This depends in part upon her credentials. Midwives can be accredited or non-accredited. Accredited midwives generally have the option of performing hospital or home births, whereas non-accredited midwifes traditionally practice only within the home. Keep in mind that a midwife’s title will reveal some information related to her educational background, certification and practice.

Most certified midwives have accreditation that includes schooling and apprentiship. A certified nurse midwife usually also requires an RN and BSN degree, though there are exceptions to the rule. Depending on a midwife’s credentials, they may deliver your baby in a hospital or in your home.

Non-accredited midwives are also schooled and apprenticed in natural birthing processes, but traditionally have less schooling or are not credentialed in the same manner as accredited midwives. They are not, for example, required to uphold regulations, and therefore there is less documentation related to their skills and abilities. If you are expecting your first baby, it might bring you more peace of mind to work with a certified midwife.


A wonderful addition to the birthing process is working with a doula. A doula is also often referred to as a labor coach or assistant. Doulas have been credited with relaxing many soon-to-be moms during the labor process. Doulas work to reduce your stress level while in labor so as to produce a delivery with fewer complications and problems. A doula will attend to you continually throughout the birthing process. Like midwives, a majority of doulas are certified as childbirth assistants. To find a doula near you, contact the Doulas of North America or DONA association. A midwife might be able to recommend a doula for you.

Doulas are credited with aiding laboring women in many ways. Services traditionally offered include:

* physical comfort techniques
* aromatherapy
* massage
* meditation
* breathing assistance
* labor positions education
* assistance with birth plan development
* pre-natal and post-natal physical and mental support
* childcare during labor

Generally, services vary according to practice.
Many moms-to-be worry that having a doula present means there is no place for their husbands. Ask any doula however, and she’ll tell you this is not the case. She will attend to the mom to be as much or as little as necessary, while at the same time allowing dad to partner in the labor process as much or as little as he likes.

Friday, March 5, 2010

Week Eight

Your Baby's Development

Marveling over a baby's tiny fingers and toes is one of the joys of the first day of life. Those fingers and toes are just beginning to form this week, and the arms can even flex at the elbows and wrists. The eyes are becoming more obvious because they’ve begun to develop pigment (color) in the retina (back of the eye).

Also, the intestines are getting longer and there isn’t enough room for them in the baby’s abdomen, so they protrude into the umbilical cord until week 12.

By now, the beginnings of the buds that will develop into your baby's genitals have made their appearance, although they've not yet developed enough to reveal whether your baby is a boy or a girl.

Your Body

Pregnancy symptoms such as a missed period, nausea, extreme fatigue, or tight clothes due to the swelling of your uterus have probably prompted you to wonder whether you're pregnant. Once you have confirmation of your pregnancy from a home pregnancy test or blood or urine test at the doctor's office, you should call and schedule your first prenatal visit. Your pregnancy may be monitored by one of several health care professionals, including an obstetrician, nurse practitioner, midwife, or family doctor. If your pregnancy is considered high risk (for example, if you have had multiple miscarriages, are older than 35, or have a history of pregnancy complications), your doctor may want to see you as early as possible and more often during the course of your pregnancy.

Good prenatal care is extremely important for the health and safe delivery of your baby, so be sure to make prenatal appointments a top priority.

Thursday, March 4, 2010

Eating During Pregnancy

Eating well during pregnancy is more than simply increasing how much you eat. You must also consider what you eat.

Although you need about 300 extra calories a day — especially later in your pregnancy, when your baby grows quickly — those calories should come from nutritious foods so they can contribute to your baby's growth and development.
Eating Well When You're Pregnant

Do you wonder how it's reasonable to gain 25 to 35 pounds (on average) during your pregnancy when a newborn baby weighs only a fraction of that? Although it varies from woman to woman, this is how those pounds may add up:

* 7.5 pounds: average baby's weight
* 7 pounds: extra stored protein, fat, and other nutrients
* 4 pounds: extra blood
* 4 pounds: other extra body fluids
* 2 pounds: breast enlargement
* 2 pounds: enlargement of your uterus
* 2 pounds: amniotic fluid surrounding your baby
* 1.5 pounds: the placenta

Of course, patterns of weight gain during pregnancy vary. It's normal to gain less if you start out heavier and more if you're having twins or triplets — or if you were underweight before becoming pregnant. More important than how much weight you gain is what makes up those extra pounds.

When you're pregnant, what you eat and drink is the main source of nourishment for your baby. In fact, the link between what you consume and the health of your baby is much stronger than once thought. That's why doctors now say, for example, that no amount of alcohol consumption should be considered safe during pregnancy.

The extra food you eat shouldn't just be empty calories — it should provide the nutrients your growing baby needs. For example, calcium helps make and keep bones and teeth strong. While you're pregnant, you still need calcium for your body, plus extra calcium for your developing baby. Similarly, you require more of all the essential nutrients than you did before you became pregnant.

Wednesday, March 3, 2010

Birth Plans

In the happy haze of early pregnancy, you're probably already thinking of baby names and planning to shop for baby clothes. The reality of labor and birth may seem extremely far off — which makes this the perfect time to start planning for the arrival of your baby by creating a birth plan that details your wishes.

What's a Birth Plan?

The term birth plan can actually be misleading — it's less an exact plan than a list of preferences. In fact, the goal of a birth plan isn't for you and your partner to determine exactly how the birth of your child will occur — because labor involves so many variables, you can't predict exactly what will happen. A birth plan does, however, help you to realize what's most important to you in the birth of your baby.

While completing a birth plan, you'll be learning about, exploring, and understanding your labor and birthing options well before the birth of your child. Not only will this improve your communication with the people who'll be helping during your delivery, it also means you won't have to explain your preferences right at the moment when you're least in the mood for conversation — during labor itself.

A birth plan isn't a binding agreement — it's just a guideline. Your doctor or health care provider may know, from having seen you throughout the pregnancy, what you do and don't want. Also, if you go into labor when there's an on-call doctor who you don't know well, a well thought-out birth plan can help you communicate your goals and wishes to the people helping you with the labor and delivery.

What Questions Does a Birth Plan Answer?

A birth plan typically covers three major areas:

1. What are your wishes during a normal labor and delivery?

These range from how you want to handle pain relief to enemas and fetal monitoring. Think about the environment in which you want to have your baby, who you want to have there, and what birthing positions you plan to use.

2. How are you hoping for your baby to be treated immediately after and for the first few days after birth?

Do you want the baby's cord to be cut by your partner? If possible, do you want your baby placed on your stomach immediately after birth? Do you want to feed the baby immediately? Will you breastfeed or bottle-feed? Where will the baby sleep — next to you or in the nursery? Hospitals have widely varying policies for the care of newborns — if you choose to have your baby in a hospital, you'll want to know what these are and how they match what you're looking for.

3. What do you want to happen in the case of unexpected events?

No one wants to think about something going wrong, but if it does, it's better to have thought about your options in advance. Since some women need cesarean sections (C-sections), your birth plan should probably cover your wishes in the event that your labor takes an unexpected turn. You might also want to think about other possible complications, such as premature birth.

Factors to Consider

Before you make decisions about each of your birthing options, you'll want to talk with your health care provider and tour the hospital or birthing center where you plan to have your baby.

You may find that your obstetrician, nurse-midwife, or the facility where they admit patients already has birth-plan forms that you can fill out. If this is the case, you can use the form as a guideline for asking questions about how women in their care are routinely treated. If their responses are not what you're hoping for, you might want to look for a health provider or facility that better matches your goals.

And it's important to be flexible — if you know one aspect of your birthing plan won't be met, be sure to weigh that aspect against your other wishes. If your options are limited because of insurance, cost, or geography, focus on one or two areas that are really important to you. In the areas where your thinking doesn't agree with that of your doctor or nurse-midwife, ask why he or she usually does things a certain way and listen to the answers before you make up your mind. There may be important reasons why a doctor believes some birth options are better than others.

Finally, you should find out if there are things about your pregnancy that might prevent certain choices. For example, if your pregnancy is considered high risk because of your age, health, or problems during previous pregnancies, your health care provider may advise against some of your birthing wishes. You'll want to discuss, and consider, this information when thinking about your options.

Tuesday, March 2, 2010

Week Seven

Your Baby's Development

Your baby is constantly adapting to life inside the uterus. By this week, the umbilical cord has formed. It will be your baby’s connection to you throughout your pregnancy, providing oxygen and nourishment for your baby and disposing of your baby's wastes. In addition, your baby's digestive tract and lungs continue to form.

Are you waiting impatiently to see your baby's face on his or her birth day? You have a long way to go until then, but in the meantime, your baby's face is taking shape. The mouth, nostrils, ears, and eyes are some of the facial features that become more defined this week.

Dreaming of a son or daughter to play ball with? The arm bud that developed just last week has a hand on the end of it, which looks like a tiny paddle.

Your Body

Pregnancy causes many changes in your cervix. By this week you'll have developed a mucous plug, which forms in the opening of the cervical canal and seals off the uterus for protection. (Eventually you'll lose this plug as your cervix dilates in preparation for labor.)

Friday, February 26, 2010

Week Six

Your Baby's Development

By week 6, your baby’s brain and nervous system are developing at a rapid pace. Optic vesicles, which later form the eyes, begin to develop this week on the sides of the head, as do the passageways that will make up the inner ear.

Your baby's heart will begin to beat around this time, and it may even be detected on ultrasound examination. And the beginnings of the digestive and respiratory systems are forming, too. Small buds that will grow into your baby's arms and legs also appear this week.

Because their legs are curled up against the torso for much of the pregnancy, making a full-length measurement difficult, babies often are measured from the crown to rump rather than from head to toe. This week, your baby only measures 0.08 to 0.2 inches (2 to 5 millimeters) from crown to rump!

Your Body

Common pregnancy complaints may hit in full force this week. You may feel extreme fatigue as your body adjusts to the demands of pregnancy. And tender, aching breasts and nausea and vomiting (morning sickness) may leave you feeling less than great. Despite its name, morning sickness can occur at any hour or all day, so don't be surprised if your queasy stomach doesn't pass by noon. Nausea isn't the only thing that has you running to the toilet, though — hormonal changes and other factors, such as your kidneys working extra hard to flush wastes out of your body, cause you to urinate more frequently, too.

Thursday, February 25, 2010

Leg Cramps

Cramps in your muscles are common during pregnancy. They may be caused by the weight you are carrying, circulation changes, or calcium deficiency.


* Regular exercise
* Adequate calcium intake
* When the cramp begins, bring your toes towards you, and massage the muscle

To try to prevent leg cramps, I'd recommend that you do a bit of stretching before bed. One of the easiest exercises that you can do is to take a large book, like a telephone book and stand on it. Place your feet on the book so that you can drop your heels off of one side of the book, thus stretching the calf really well.

You can also lean forward, placing your hands about shoulder height and distance on a wall. Take your right foot and step backwards, being sure that you place your heel on the ground so that you get that stretch. Repeat on the other leg.

Also try eating a banana a day! The potassium helps a lot!

Wednesday, February 24, 2010

Week Five

Your Baby's Development

Until now, the embryo has been a mass of cells, but by this point in your pregnancy a distinct shape begins to form. The neural tube, which will eventually form into the spinal cord and brain, runs from the top to the bottom of the embryo. A bulge in the center of the embryo will develop into your baby's heart. At this time, the placenta develops. It is through the placenta and its fingerlike projections, called chorionic villi, that an embryo receives nourishment from its mother.

Your Body

Even if nausea hasn't hit you yet, you'll want to steer clear of certain foods when you're pregnant. Foodborne illnesses, such as listeriosis and toxoplasmosis, may cause birth defects or even miscarriage. Here are some foods you'll want to avoid:

* soft cheeses such as feta, goat, brie, Camembert, and blue cheese
* unpasteurized milk and juices
* raw or undercooked meats, including hot dogs and deli meats
* raw eggs or foods containing raw eggs, including mousse and tiramisu
* raw shellfish
* paté

Toxoplasmosis can also be spread from soiled cat litter boxes, so try to have someone else clean the litter box during your pregnancy.

Monday, February 22, 2010

Pregnancy & Vitamins

No one will be surprised to learn that most expectant mothers seek out the best nutrition and the best pregnancy vitamins. Women have used herbs and foods to support pregnancy, birth, and breast-feeding since the beginning of historical time. Here are a few choices that appropriate for any mother and baby.

Nearly seventy five years of clinical evidence leaves no doubt that folic acid (folate) supplements prevent neural tube defects and other defects such as cleft lip and cleft palate. Folic acid is a B vitamin. It is found in a wide range of foods in very small amounts, and it is added to many bread and grain products. The embryo needs this leader of the best pregnancy vitamins during the first 45 days after conception to grow a normal brain and spinal cord.

The problem is, folic acid deficiencies can't be corrected in a single dose of this important pregnancy vitamin. If a woman is deficient in this folic acid it's possible she won't know she's pregnant before the embryo already needs folic acid for normal growth.

This is the reason folic acid is the pregnancy vitamin any woman who can become pregnant should take every day. A recommended dose is 400 micrograms (0.4 milligrams) a day before pregnancy and 800 micrograms a day during pregnancy. If you are a woman and you have any plans ever to have a baby, think folic acid now.

Unlike folic acid, vitamin B6 is seldom deficient in expecting mothers. Supplementation with vitamin B6, however, can help prevent morning sickness. Vitamin B6 supplements are helpful for women experiencing gestational diabetes. They lower blood sugars by lowering the hypersensitivity reactions that underlie the disease.

Taking supplemental vitamin C in doses of up to 2,000 mg a day to stop a cold is fine. Just beware stomach upset and diarrhea if you take a very large dose. Expectant mothers generally don't need more than 1,000 mg of vitamin C a day.

Vitamin D is necessary to maintain healthy thyroid function during pregnancy. The main use of vitamin D as a pregnancy vitamin, of course, is for making healthy bones. Women who live in northerly latitudes or who never get exposure to sun are at risk of vitamin D deficiency. Healthy bones in both mother and child require adequate calcium, phosphorous, and vitamin D.

Scientists at the Medical College of the University of South Carolina writing in the May 2004 edition of the American Journal of Clinical Nutrition report that relatively high doses of supplemental vitamin D, up to 1000 IU a day, may be needed for bone health in pregnant women and nursing mothers who are unable to spend time in the sun. If you can't get sun, consider taking a low dose of vitamin D, no more than 400 IU per day after your first trimester. Observant Muslim mothers are especially likely to benefit from additional vitamin D.

The other fat-soluble vitamins A, E, and K are rarely deficient and can't be considered pregnancy vitamins, but shortages can lead to serious symptoms. Vitamin A in doses of more than 5000 IU a day should be avoided in early pregnancy, but low-dose vitamin A supplementation after the first trimester helps the baby avoid parasites and viral infections later.

Vitamin E deficiencies can lead to tearing of the placenta. As little as 100 IU of mixed-tocopherol formula can help prevent this problem.

Vitamin K deficiency is also rare, unless the mother is taking a blood-thinning agent such as Coumadin. It's very difficult to take too much E or K, but it's not necessary to take a megadose (more than 20 times the RDA), either.

Getting enough calcium does more during pregnancy than helping make healthy bones. Calcium may reduce pregnancy-related hypertension and a dangerous complication called pre-eclampsia. Supplemental calcium is safe even in large doses, up to 2500 mg a day.

Calcium works with B vitamins, magnesium, and zinc to help the fetus mature to a healthy birth weight. Shortages of calcium, magnesium, and zinc are most likely to occur in the final trimester. It's best to start taking supplemental calcium, magnesium, and zinc in the 19th week.

Iron is important for healthy red blood cells. As the fetus grows, it develops its own blood supply. The creation of new red blood cells in both mother and child requires large amounts of iron.

Iron supplements are key to treating anemia in pregnancy, but you can't know you have iron-deficiency anemia without a blood test. Taking iron when you are not anemic is not good for you or baby - infectious microorganisms need iron, too. If you do have iron-deficiency anemia, folic acid supplements may also help.

The vitamins can also make pregnancy more comfortable. It's not unusual for pregnant women to experience painful leg cramps day or night. Eating foods that are rich in magnesium, such as leafy greens, whole grains, and fruit (the same foods that provide folic acid) helps, but often isn't enough. If the diet is providing enough magnesium and calcium, then a combination of the pregnancy vitamins B-1 (thiamine) and B-6 (pyridoxine) usually relieves this form of distress.

Miscarriage is caused by many factors, but low levels of vitamin B-12 are high on the list of known risk factors. Taking a pregnancy vitamin supplement that contains the recommended daily allowance of vitamin B-12 may help. This vitamin also prevents certain kinds of anemia not related to iron deficiency.

When there is gestational diabetes, taking the best pregnancy vitamins, especially vitamin B-6. along with chromium, once again, in therapeutic doses rather than in megadoses, helps control blood sugars. This B vitamin also helps prevent complications of diabetes in pregnant women who are diabetic when they are not pregnant.

Many women experience gallbladder problems during pregnancy. Gallbladder ailments may be relieved by s-adenosyl-methionine, also known as SAM-e. A very small dose of SAM-e, as little as 20 mg, will help relieve gallbladder pain. It isn't necessary to spend a lot of money at the supplements store buying a higher dosage, but it's OK to take more, much more, even 800 mg a day, if it's already in your supplement.

Women can help their bodies make their own SAM-e by making sure they take a balanced B vitamin every day. Combining vitamin B-6, vitamin B-12, and folic acid allows a woman's body to "recharge" SAM-e. It also prevents harmful levels of the chemical homocysteine from building up in the bloodstream. High homocysteine is surprisingly common during pregnancy, and deficiencies of B vitamins can even affect the baby during breastfeeding.

One last common condition of pregnancy that can be relieved by the best pregnancy vitamins is gingivitis. Folic acid helps, in the form of a folic acid mouthwash or a folic acid supplement.

Be sure that your supplement can be taken any time of day. You shouldn't have to take it with food.