Category Archives: Parenting & Families

Multiple Pregnancy

If you are pregnant with more than one baby—with twins, triplets, or more your pregnancy is called a multiple pregnancy. Fraternal twins are more common than identical twins and are the result of two sperm fertilizing two egg Fraternal twins may or may not be the same sex and are no more alike appearance than any other siblings. Identical twins occur less frequently are the result of one sperm fertilizing one egg, which then separates. Since identical twins carry the same genetic material, they are always the same and always look alike, and always have the same blood type. They may be mini images of each other.

During pregnancy, an increased demand is placed on the body of a woman carrying more than one baby as well as additional placentas or one larger percents. The discomforts of pregnancy are accentuated; since there is increased demand on the circulatory system and the uterus is larger in size. The chances of PIH and preterm labor are greater. For these reasons, many physicians place these women on bed rest at around 28 weeks gestation.

Women experiencing a multiple pregnancy have higher protein and calcium requirements. Additional protein is necessary to provide for adequate growth of the babies and ensure good muscle tone of the over distended uterus. Women who eat well during pregnancy decrease their chances for complications and increase the chances for delivering at term.

First Trimester During Pregnancy

Pregnancy is generally divided into three trimesters, or three periods of 3 months each, for purposes of discussion. This is done because most women experience the same general changes during each trimester.

During pregnancy, two kinds of development go on at once—the physical changes in the mother-to-be and the physical changes in the fetus. Along with the physical changes the woman experiences, some emotional changes take place. You and your partner can use these changes as opportunities to grow, to expand your awareness of yourselves and of each other, to deepen your sense of responsibility, and to become aware of what millions of other parents-to-be have experienced.

The first trimester of pregnancy is the first 3 calendar months, or through the fourteenth week of gestation. You will experience many physical and emotional changes during this time, although most of the physical changes will be more noticeable to you than to anyone else.

Physical Changes

The major physical changes that women experience during the first trimester include the following:

Uterus

For many women, a missed menstrual period is the first sign of pregnancy. Other women continue to have very light periods for the first 2 to 3 months. This lack of a regular period is due to the high levels of estrogen that the body produces to maintain the uterine lining that maintain the developing embryo.

By the time the fetus is 12 weeks old, the placenta, or afterbirth, has developed. The uterus has grown to the size of a grapefruit, with its top reaching above the pubic bone. The cervix has already begun softening.

Vagina

The vagina has begun thickening and softening. It has also turned blue to violet in color as a result of the increased blood supply to the area. Vaginal secretions have become more noticeable and will increase in amount as the pregnancy progresses.

Breasts

A tingling or prickling sensation is often felt in the breasts during the first of pregnancy. This is because the blood supply is increasing and the milk secreting glands are growing. After a few weeks or months, the prickling will disappear, but the breasts will usually continue to tingle until the third trimester.

During the eighth week, veins may become visible under the skin, and seated areas appear on the areola, the dark area surrounding. These elevated areas are the Montgomery glands, which secrete oil in preparation for breastfeeding.

Urination

Many women experience an increased need to urinate during the first trimester because the enlarging uterus is pressing on the bladder. This can usually eases during the second trimester, as the uterus rises out of the pelvis. Even though it means more trips to the bathroom, you should drink plenty of fluids to maintain good kidney function and to provide the water to metabolize the protein you eat.

Digestion

About half of all pregnant women feel nauseated and may vomit during early pregnancy, and sometimes also in later pregnancy. This condition is called morning sickness, although it can occur at any time during the day. Morning sickness is attributed to an increase in hormone levels, a lack of vitamin B5 and/or low blood sugar. Eating foods high in B vitamins and consumption of small high-protein meals throughout the day usually help this condition.

In addition to nausea, some women also have trouble with indigestion and heartburn. The hormones relaxin and progesterone relax the smooth muscles in the body, including the sphincter at the top of the stomach, which keeps food in the stomach. Progesterone is also responsible for relaxing the intestines somewhat, thereby slowing digestion and making constipation easier. Eating a diet high in fiber (fresh fruits and vegetables, and whole tarts), drinking plenty of fluids, and exercising regularly help to minimize constipation.

Skin

The hormones of pregnancy can affect your skin either positively or negatively. Many women experience the glow of pregnancy, and their skin radiance. Others are not so fortunate and develop acne. Continue to eat a good diet and drink plenty of water. Wash your face two or three times a day with a gentle cleanser and apply moisturizer to dry areas. Avoid the temptation to pick at or squeeze the blemishes. This will only increase the likelihood of infection and scarring. Choose makeup that does not clog the pores or try limiting the time you wear it. Wash the applicators or purchase new blush brushes or powder “puffs.” If the acne is severe, you may need to see a dermatologist. Make sure that he knows you are pregnant. Two common medications used for acne, Accutane and Retin A, should not be used during pregnancy.

Fatigue

Pregnancy brings changes to every system in the body, and the changes require a great deal of physical and emotional energy. Properly resting is extremely important for an expectant mother. You should not feel guilty about resting during the day or about going to bed early. You need rest to adjust to pregnancy.

Amniocentesis

Amniocentesis is a test to detect abnormalities in the baby. It may also be done to assess fetal lung maturity if induction of labor or cesarean delivery is indicated. The test is performed by administering a local anesthetic, then drawing a sample of amniotic fluid using a long needle inserted through the abdominal and uterine walls. It should be done in conjunction with ultrasound, which will show the location of the fetus, the placenta, and the umbilical cord.

The amniotic fluid is sent to a lab for culturing and testing. Certain tests such as those for Tay-Sachs disease, Hunter’s syndrome, neural tube defects, and fetal lung maturity can be performed immediately. These tests measure chemicals produced by the baby that are present in the amniotic fluid. To determine fetal lung maturity, the amniotic fluid is examined for the specific phospholipids that are present when a baby’s lungs are mature.

Most tests require that the fetal cells be isolated and given sufficient time to multiply, usually 2 to 4 weeks. Then a complete chromosomal analysis is done to detect the presence of Down syndrome or other genetic abnormalities. The sex of the baby is also established. When amniocentesis is used for detecting abnormalities, it is generally performed between 16 and 18 weeks gestation. Before 14 weeks, there usually is insufficient amniotic fluid. Some caregivers are performing amniocentesis between 11 and 13 weeks. But one study found that when amniocentesis is performed before 86 days, an increase in foot deformities (turned-in and clubfeet) was observed. When testing for gestational maturity, the procedure is done in the last trimester.

Amniocentesis is a very valuable procedure, but according to many experts, it can be misused. The risks include some chance of blood exchange between the woman and baby, creating a greater Rh incompatibility when testing for the condition; infection of the amniotic fluid; peritonitis; blood clots; placental hemorrhage; injury to the baby; and even premature labor Amniocentesis should definitely not be done just to satisfy curiosity about the baby’s sex. And, unless you plan to terminate your pregnancy if an abnormality is found, or unless your doctor plans to alter your care, it is questionably whether you should have this test done just for the genetic information.

Hypertension in Pregnancy

Hypertension (high blood pressure) that occurs during pregnancy is called Pregnancy-Induced Hypertension (PIH). Most women who develop PIH did not have hypertension before pregnancy and will not have it after. PIH was formerly known as toxemia. While the cause of PIH is unknown, some studies suggest that the blame lies with an imbalance of the substances that regulate the constriction and dilation of the blood vessels. The risk factors include a diet low in protein or calcium, a history of preeclampsia prior to 32 weeks gestation, chronic high blood pressure, kidney disease, lupus, diabetes, multiple pregnancy, age (under 20 or over 35), and being overweight. A new theory states that PIH may be an immune response to a new sex partner since 85 percent of cases occur in first-time pregnancies. Several studies have shown that a good diet can reduce the risk of developing PIH. A diet containing 75 to 100 grams of protein and 1,500 to 2,000 milligrams of calcium recommended.

PIH affects both the woman and the fetus. High blood pressure constricts mood flow to the uterus. This can result in the baby receiving less oxygen and nutrients, which will affect his growth. In addition, the placenta may separate from the wall of the uterus before delivery and result in bleeding and shock. If untreated, PIH can become preeclampsia, which is characterized by vim blood pressure, protein in the urine, sudden weight gain, and swelling of the face and hands. It may be necessary to induce labor if the blood pressure do not controlled. This may lead to a premature infant. Rarely, preeclampsia increases to eclampsia, which is marked by convulsions and coma.

Treatment of PIH consists of bed rest for mild conditions. Occasionally, a caiman must be hospitalized. If the blood pressure is not controlled, delivery by induction of labor or cesarean section may be necessary to save the lives of the woman and baby. The medication magnesium sulfate is administered intravenously to prevent convulsions. The risk of seizures diminishes 48 hours after delivery of the baby.

Traveling During Pregnancy

  • If you are like most women, traveling during pregnancy is no problem, as long as you follow a few guidelines. These guidelines are:
  • Check with your caregiver to make sure there are no special healthcare contacts that would prevent you from traveling.
  • Try to plan any trips for your second trimester, when comfort is the greatest.
  • While traveling, walk around often to improve circulation.
  • Wear comfortable shoes and clothing.
  • Take along light snacks and juice to prevent hunger and decrease nausea.
  • Do not take motion sickness pills or any other medications before checking walk your caregiver.
  • Take time to eat regular, nutritious meals.
  • Eat plenty of high fiber foods to ease constipation.
  • Get your usual amount of sleep and rest often. Elevate your feet.
  • If you are traveling far from home, take a copy of your medical record and get the name of a doctor or facility where you could go for treatment if nectarine.
  • If traveling by car, do not ride for more than 6 hours a day. Stop every 1 to 2 hours to walk around. Always wear a seat belt.
  • If traveling by air, sit in an aisle seat for the greatest comfort. Wear layers of clothing so that you can adjust as the cabin temperature changes. Drink plenty of fluids.
  • If traveling overseas, drink only bottled beverages. Do not use ice in your drinks and do not eat raw, unpeeled fruits or vegetables. Also, avoid raw meat, and make sure that any milk you drink has been pasteurized.

The best guideline you can follow is to keep your plans flexible and to change them according to your body’s signals. If you use common sense, traveling during pregnancy can be a pleasure, not an inconvenience.

Oxytocin Challenge Test

Oxytocin Challenge Test (OCT) is done in the hospital to help determine how well the baby will undergo the stress of labor. The OCT is also known as the Contraction Stress Test.

Oxytocin is a medication that causes uterine contractions. While reclining on a 45-degree angle, the woman is given oxytocin intravenously until she has contractions 3 to 4 minutes apart for a full half-hour. At the same time, the heart rate is electronically monitored to check the effect of the contractions on the baby. If the results are positive—that is, the fetal heart rate appears normal during the stress of the contractions—the doctor may recommend a wean birth, since the baby may not be able to tolerate the stress of labor. If the results are negative—that is, the heart rate remains normal during the contractions—the baby will most likely do well during labor.

When taking the OCT, avoid lying flat on your back. This can cause your blood pressure to drop, decreasing oxygen to the baby and possibly causing the appearance of fetal distress on the monitor.

Length of Pregnancy

The average length of pregnancy is 280 days. This is about 9 calendar months or 10 lunar months. A lunar month is the time it takes to go from full moon to full moon – 28 days.

Your doctor calculated your estimated due date by adding 7 days to the first day of your last normal menstrual period and then counting back 3 months. For example, if the first day of your last menstrual period was February 15, he added 7 days, which brought the date to February 22, then subtracted 3 months, for an expected due date of November 22. This is about 280 days after February 15. The baby would be only about 266 days old on November 22, but the date of the last menstrual period is used because the actual date of conception is usually unknown and could be as early as day 5 or 6 of the menstrual cycle. Only about 4 percent of women carry their babies for exactly 280 days, but 66 percent deliver within 10 days before or after their due dates. The due date is only an estimate, based on an average of all pregnancies. Your baby may take more or less time to develop, the same way that some babies take more or less time to get their first tooth.

Emotional Symptoms During Second Trimester Pregnancy

Most women find the second trimester to be a more positive experience that the first, as they are now beginning to feel the movements of the life with them. Most husbands by now have accepted the existence of the pregnancy, and are as excited as the woman about the movements of the baby. During the second trimester, men frequently also become more aware of their wife’s growing dependence on them. As the pregnancy progresses, the woman may feel more vulnerable and may need her mate’s attention more. She may want him to become more involved with the pregnancy and the baby. In addition, she may become overly concerned for her husband’s safety. Meanwhile, the husband may share the woman’s interest in the pregnancy, or he may feel an increased creative interest in his work or hobby. He may gain weight or show other symptoms of pregnancy. These are all ways in which expectant mothers and fathers deal with the stresses and changes that are occurring. It is important for both partners to be aware of and to talk about their feelings, especially when friction arises between them.

A woman’s dreams may become very real during this trimester and are sometimes disturbing. Dreams are a way of bringing fears to consciousness, where they can be dealt with more easily. If a woman refuses to acknowledge her fears, she may suffer increasing anxiety.

Pregnancy Nutrition Guide

As your pregnancy progresses the nutritional demands of your body increases. A look at these increasing needs by trimester can provide a good first insight.

Pregnancy First Trimester Nutrition

During the early weeks of pregnancy, you may not be aware of the baby with your body. Therefore, you should consume an adequate diet even before you become pregnant. Once you realize that you are pregnant, you may experience morning sickness, which tends to minimize thoughts of food. But even in pregnancy, you need to make sure that you eat a good diet. This can be difficult, since your nutritional requirements at this point are already the same as those for a non-pregnant woman, with the exception of the additional folic acid requirement.

Lack of certain nutrients in the diet, primarily vitamin B6, is thought to cause morning sickness. Morning sickness may also occur because of dime sugar after not eating all night. Some women experience nausea the day, however, especially if they go for long periods without. Many women find that natural remedies can bring relief from morning sickness. However, if natural remedies do not help you, and nausea and vomiting is a severe problem, your doctor can prescribe medication. Gratefully sickness usually disappears by the fourth month.

Pregnancy Second Trimester Nutrition

During the second trimester, nutritional needs increase, and you should begin additional calories, vitamins, and minerals by following a pregnancy diet. The baby puts on very little weight during the second However, the maternal tissues greatly increase. The woman begins putting down a store of fat for her body to utilize during lactation. Her uterus and breasts enlarge, the volume of amniotic fluid increases, the placenta in size, and the blood volume expands. Therefore, increased protein intakes are essential.

Pregnancy Third Trimester Nutrition

During the last trimester, the baby gains weight rapidly. His brain grows the last 2 months, and his liver stores up iron. Continue with your pregnancy diet during this time—and beyond, if you wish. You must take in sufficient calories and protein to ensure optimum nutrition of the baby’s brain and body. Dieting at this point is not beneficial for either of you, and fasting before doctor’s appointments to minimize Lam is foolish. Make certain that you eat well, and your weight gain will guarantee the health of both you and your baby.

If you experience increased swelling as your due date approaches, try adding more protein to your diet. In rare cases, swelling puts pressure on the nerves in the wrist, resulting in tingling, numbness, and pain in the hands. This is called carpal tunnel syndrome. Additional vitamin B6 may help relieve this condition or prevent its further development. The symptoms of carpal tunnel syndrome will gradually subside following delivery.

Posture During Pregnancy

The way you use the different parts of your body to move, as well as to hold, and carry things, is called body mechanics. Having proper body mechanics is important during pregnancy to help minimize discomforts as your body gets larger. The first step in achieving proper body mechanics is maintaining good posture. Good posture is essential throughout pregnancy because your center of gravity changes. You will be tempted to compensate change by slumping. Instead, you should maintain the same good posture before becoming pregnant. Standing erect lessens back discomfort, improves digestion, and enhances body image.

While standing, the way you hold your head influences the position of your body. If you let your head hang forward, your body will droop wilted flower. Instead, think tall! Hold your head up, with your chin in and your neck straight. Lift your shoulders up and pull them back. Good posture will keep you from cramping your rib cage, which can make something difficult and possibly cause indigestion.

Put special attention to your pelvic area, which contains the weight of the baby. Think of your pelvis as a bowl filled with liquid. To prevent the liquid from spilling out, tilt the “bowl” back by tightening your abdominal muscles. By keeping the pelvis tilted back, you can prevent tension in the muscles of your lower back. You can maintain proper alignment by bending your knees slightly and keeping your body weight at your feet. Place your body weight on the center of each foot. If you stand for long periods, put one foot on a small stool to flex the hip. While sitting in a chair, use the back of the chair as a guide to sit up against. Do not slump forward. Straight-back chairs are preferable over cushioned chairs during pregnancy for this reason. Place a pillow behind your neck or your back to increase your comfort. Rest the entire length draw thigh on the seat of the chair. The chair seat should be high enough to keep your knees even with your hips.

While sitting, or sitting Indian style, is an excellent position during pregnancy. It is comfortable and improves the circulation in the legs while stretching and increasing the flexibility of the inner thigh muscles. Sit this way when possible; for example, when you watch television, read the newspaper, wear clothes, or peel potatoes. If your legs become tired, stretch them out in front of you.

The supine position or lying flat on your back, for extended periods of time is not recommended after the first trimester. This position puts the weight of the baby and uterus on your major vessels, causing them to be compressed. This can lower your blood pressure, thereby reducing the count of blood traveling to the placenta and the baby. If you must lie on your back during an examination, for example, modify the position by placing a pillow in the small of your back for support and bending your knees. Refrain from doing exercises that require you to lie on your back.

Side-lying is a position that takes the weight of the baby off your back and groin, and allows the joints to be aimed loosely. A pillow placed between your legs will make it easier for you to relax. You may feel more comfortable on your abdomen. It is a three-quarter position. Place your lower arm behind your back and position your upper arm and leg forward, supported by pillows.

To get up from a supine position, first roll onto your side and then yourself to a sitting position with your arms. If you are in bed, swing your over the side of the bed. Be careful not to twist your body as you get up technique will help you to avoid strain to both your back and abdominals.

When walking, remember all the points of correct posture described previously. Bring your legs straight forward from the hip. Do not sway them sideways in a “waddle.”

Be careful when climbing stairs. Lift your body up using your legs, r than pulling yourself up with your arms. Lean slightly forward as you go placing your foot completely on each step. During your postpartum, climb steps slowly, tightening your abdominal and pelvic floor muscles. Let your leg muscles do the work.

Many women, especially those with small children or toddlers, find some lifting is necessary during pregnancy. Incorrect lifting can put excess strain on the back and the pelvic floor. Therefore, it is important to learn to lift correctly.

Avoid lifting heavy objects. Lift only what you can lift easily with arm. To lift, get close to the object and lower yourself into a squat, bending the knees, not at the waist. Keep your feet parallel and your back straight, as you lift the object; straighten your legs without twisting your body. Alternate method is to place one foot in front of the other and slowly lo yourself to one knee. Lift the object by pushing yourself up with your r foot, keeping your back straight.

A small child can climb onto a stool or chair, enabling you to lift him her without straining your back.