Pregnancy All-in-One For Dummies

Introduction

Prospective parents are truly curious about everything related to pregnancy, from when the baby’s heart is formed to whether eating sushi or dyeing your hair is okay. If this describes you, you’ve come to the right place. In one helpful reference guide, Pregnancy All-in-One For Dummies offers the answers to many of your pregnancy-related questions, from fetal development to workouts for moms-to-be to healthy weight gain and more.

About This Book

Pregnancy should be a joy, not a worry. Yet pregnant women are, by nature, already anxious about whether anything they do or eat may hurt the baby. The source of all this anxiety? Often it’s information on pregnancy — in print, online, or from the mouths of well-meaning but clueless friends and family — that is outdated, lacks scientific basis, or is exaggerated for shock effect. The result is that many pregnant women and their partners end up incredibly worried about something they’ve read or heard.

This comprehensive, scientifically correct guide presents the facts of pregnancy based on real scientific data, and it answers many commonly asked questions — all while encouraging the humor and light-heartedness that are part of the miraculous process of having a baby. A big part of the philosophy behind this book is to reassure pregnant women instead of adding to the unnecessary worries they already have.

Prospective parents also want to know about the medical aspects of pregnancy. When are fingers developed? Which blood tests should be done, and why? What options are available for detecting various problems? This book addresses these topics, too, creating what is essentially a medical text on obstetrics for the layperson.

This book provides a lot of factual information, but it isn’t gospel. Many of the topics discussed apply to pregnancy in general, but your particular situation may have unique aspects that warrant different or extra consideration, so use this book as a companion to regular medical care.

Sidebars (boxes of text) in this book give you a more in-depth look at a certain topic. Although they further illuminate a particular point, these sidebars aren’t crucial to understanding the rest of the book. Feel free to read them or skip them. You can pass over the text that accompanies the Technical Stuff icon as well. The text associated with this icon gives some interesting details about pregnancy, but if you don’t read it, you can still come away with the information you need.

Within this book, you may note that some web addresses break across two lines of text. If you’re reading this book in print and want to visit one of these web pages, simply key in the web address exactly as it’s noted in the text, pretending the line break doesn’t exist. If you’re reading this as an e-book, you’ve got it easy — just click the web address to be taken directly to the web page.

Foolish Assumptions

We made some assumptions about you and what you want out of a pregnancy book:

You may be a woman who is considering pregnancy, planning to have a baby, or already pregnant.

You may be the partner of the mother-to-be.

You may know and love someone who is or plans to become pregnant.

You want to find out more about pregnancy but have no interest in becoming an expert on the topic.

You want reliable information on a variety of topics related to pregnancy, from information on the development of the fetus to how to stay fit as your body changes, whether and how to breastfeed, and more.

If you fit any of these criteria, then Pregnancy All-in-One For Dummies gives you the information you’re looking for.

Icons Used in This Book

Like other For Dummies books, this one uses icons to guide you through the information.

technicalstuff This icon signals information that delves a little deeper than usual into a medical explanation.

remember This icon flags information that’s particularly worth keeping in mind.

tip This icon marks bits of advice about handling minor discomforts and other challenges you encounter during pregnancy.

warning This icon points out situations and actions that a pregnant woman clearly should avoid.

Beyond the Book

In addition to the material in the print or e-book you’re reading right now, this product comes with some access-anywhere goodies on the web. Check out the free Cheat Sheet for info on what to expect when you’re admitted to the hospital, how you can avoid some of the maladies that plague pregnant women (like heartburn), and strategies that can help you find time for fitness and motherhood. To get this Cheat Sheet, simply go to www.dummies.com and search for "Pregnancy All-in-One For Dummies Cheat Sheet" in the Search box.

Where to Go from Here

If you’re the particularly thorough type, go ahead and read this book from cover to cover. If you just want to find specific information and then close the book, take a look at the table of contents or at the index. Dog-ear or bookmark the pages that are especially interesting or relevant to you. Add comments or write little notes in the margins. Have fun, and most of all, enjoy your pregnancy!

Book 1

Getting Started with Your Pregnancy Preparation

Contents at a Glance

Chapter 1: Seeing Double (Lines): And So It Begins

Seeing Signs — of Pregnancy, That Is

Determining Whether You’re Pregnant

A Week-by-Week Overview of Pregnancy

Common Tests during Pregnancy

Chapter 2: Practitioners, Prenatal Visits, and Maintaining Good Health

Selecting the Right Practitioner for You

Planning Prenatal Visits

Keeping Your Medicines and Vaccinations in Check

Understanding the Effects of Alcohol and Other Drugs on Your Baby

Chapter 3: Diet, Exercise, and Expectant Moms

Looking at Healthy Weight Gain

Taking Stock of What You’re Taking In

Determining Which Foods Are Safe

Considering Special Dietary Needs

Working Out for Two

Chapter 4: Oh, the Changes You’ll See: Physical, Emotional, and Embarrassing Unmentionables

Bracing for Emotional Changes

Prepping for Physical Changes

Looking at Lifestyle Changes

Working during Pregnancy: A Different Type of Labor

Chapter 5: Creating a Birth Plan

What’s a Birth Plan? And Why Would You Want One?

Your Birth-Plan Options: An Overview

Making Smart Choices When You’re Not a Doctor

Avoiding Potential Birth-Plan Pitfalls

Chapter 1

Seeing Double (Lines): And So It Begins

IN THIS CHAPTER

Knowing what symptoms to look for

Getting the answer to that all-important question: Are you pregnant?

Knowing what to expect as your pregnancy progresses

Scheduling doctor appointments and routine tests

So you think you may be pregnant! Or maybe you’re hoping to become pregnant soon. Either way, it’s important to know what to look for so that you can find out whether you’re pregnant as early as possible. This chapter takes a look at some of the most common signals that your body sends you in the first weeks of pregnancy and offers advice for confirming your pregnancy and getting it off to a great start.

Seeing Signs — of Pregnancy, That Is

So assume it has happened: A budding embryo has nestled itself into your womb’s soft lining. How and when do you find out that you’re pregnant? Quite often, the first sign is a missed period. But your body sends many other signals — sometimes even sooner than that first missed period — that typically become more noticeable with each passing week.

Honey, I’m late! You may suspect that you’re pregnant if your period hasn’t arrived as expected. By the time you notice you’re late, a pregnancy test will probably yield a positive result (see the next section for more on pregnancy tests). Sometimes, though, you may experience one or two days of light bleeding, which is known as implantation bleeding, because the embryo is attaching itself to your uterus’s lining.

You notice new food cravings and aversions. What you’ve heard about a pregnant woman’s appetite is true. You may become ravenous for pickles, pasta, and other particular foods yet turn up your nose at foods you normally love to eat. No one knows for sure why these changes in appetite occur, but experts suspect that these changes are, at least partly, nature’s way of ensuring that you get the proper nutrients. You may find that you crave bread, potatoes, and other starchy foods, and perhaps eating those foods in the early days is actually helping you store energy for later in pregnancy, when the baby does most of its growing. As with any other time in life, though, be careful not to overeat. You may also be very thirsty early in pregnancy, and the extra water you drink is useful for increasing your body’s supply of blood and other fluids.

Your breasts become tender and bigger. Don’t be surprised if you notice that your breasts become larger during the first portion of your pregnancy. In fact, large and tender breasts are often the first symptom of pregnancy that you feel because very early in pregnancy, levels of estrogen and progesterone rise, causing immediate changes in your breasts.

Determining Whether You’re Pregnant

Well, are you or aren’t you? These days, you don’t need to wait to get to your practitioner’s office to find out whether you’re pregnant. You can opt instead for self-testing. Home tests are urine tests that give simply a positive result (often showing two lines) or negative result (showing only one line); some use little plus (positive) and minus (negative) signs. These tests are very accurate for most people. Your practitioner, on the other hand, may perform either a urine test similar to the one you took at home or a blood test to confirm that you’re pregnant.

Getting an answer at home

Suppose you notice some bloating or food cravings, or you miss your period by a day or two. You want to know whether you’re pregnant, but you aren’t ready to go to a doctor yet. The easiest, fastest way to find out is to go to the drugstore and pick up a home pregnancy test. These tests are basically simplified chemistry sets, designed to check for the presence of human chorionic gonadotropin (hCG, the hormone produced by the developing placenta) in your urine. Although these kits aren’t as precise as laboratory tests that look for hCG in blood, in many cases, they can provide positive results very quickly — by the day you miss your period, or about two weeks after conception.

remember The results of home pregnancy tests aren’t a sure thing. If your test comes out negative but you still think you’re pregnant, retest in another week or make an appointment with your doctor. A urine test is positive at a level of about 20–50 IU/L, while a blood test is positive at a level of 5–10 IU/L, depending on the test. So a blood test will be positive a little earlier than a urine test. An ultrasensitive blood test can even detect an hCG level of about 1–2 IU/L.

Going to your practitioner for answers

Even if you had a positive home pregnancy test, most practitioners want to confirm this test in their office before beginning your prenatal care. Your practitioner may decide to simply repeat a urine pregnancy test or to use a blood pregnancy test instead.

A blood pregnancy test checks for hCG in your blood. This test can be either qualitative (a simple positive or negative result) or quantitative (an actual measurement of the amount of hCG in your blood). The test your practitioner chooses depends on your history and your current symptoms and on her own individual preference. Blood tests can be positive even when urine tests are negative.

REACTING WHEN YOUR PARTNER BREAKS THE NEWS

When your partner tells you the big news, try to mirror her reaction, at least outwardly. If her reaction is Oh … heck, you can go along in that vein also, at least for a minute or two. Remember, though, that she’s gauging your reaction to the news, and if you act like having a baby is a huge imposition in your life, she’ll be really upset, even if it is going to be a huge imposition and even if she just said the same thing five minutes before. Try to throw in a few encouraging statements about how you wanted kids eventually, how having a baby will be fun in the winter when there’s nothing else to do, or whatever encouraging babble you can come up with at a stressful time.

Some women get very creative with their announcements, from filling the living room with balloons to baking a cake with a pair of booties inside. Just try not to choke on one, literally or figuratively. If she’s gone all out to break the news, you can safely bet that she’s really excited, so make sure to be as supportive as possible.

Even if you’ve been trying to conceive forever, an initial reaction of fear isn’t uncommon. Remember that your partner may also be feeling some sudden doubts and fears, and allow her to express them. Under no circumstances is We spent $20,000 for fertility treatments and now you’re not sure this is the right time?! the right response to her concerns.

Calculating your due date

Only 1 in 20 women actually delivers on her due date — most women deliver anywhere from three weeks early to two weeks late. Nonetheless, it’s important to pinpoint the due date as precisely as possible to ensure that the tests you need along the way are performed at the right times. Knowing how far along you are also makes it easier for your doctor to see that the baby is growing properly.

The average pregnancy lasts 280 days — 40 weeks — counting from the first day of the last menstrual period. This day is used to calculate your due date.

tip If your cycles are 28 days long, you can use a shortcut to determine your due date. Simply subtract three months from your last menstrual period and add seven days. If your last period started on June 3, for example, your due date would be March (subtract three months) 10 (add seven days). If your periods don’t follow 28-day cycles, don’t worry. You can establish your due date in other ways. If you’ve been tracking ovulation and can pinpoint the approximate date of conception, add 266 days to that date (the average time between the first day of your last menstrual period and ovulation is about 14 days, or 2 weeks).

If you’re unsure of the date of conception or the date your last period started, an ultrasound exam during the first three months can give you a good idea of your due date. A first-trimester ultrasound predicts your due date more accurately than an ultrasound done in the second or third trimester.

tip You can also use a pregnancy wheel to calculate how far along you are. To use this handy tool, line up the arrow with the date of your last menstrual period and then look for today’s date. Just below the date, you see the number of weeks and days that have gone by. (If you know the date of conception rather than your last period, there’s a line on the wheel corresponding to this, too.) You can find online wheels as well as apps that you can download to calculate your due date.

A Week-by-Week Overview of Pregnancy

As indicated throughout this book, pregnancy is usually referred to as a 40-week enterprise, which is a tad misleading. The pregnancy starts at conception, which — with a normal 28-day cycle — is two weeks after the first day of your last menstrual period. So if you start at conception, pregnancy is only 38 weeks, but obstetricians use 40 weeks because most women don’t know when they conceive but do remember when their last period was.

remember Here are a few things to remember as you read this week-by-week guide:

Many of the things discussed in a particular week may still be important at other times throughout the pregnancy. So just because the ultrasound is mentioned at 20 weeks doesn’t mean it can’t be done at any other time.

Some things included in this chapter are optional and may not be necessary for everyone.

The week/weeks assigned to prenatal tests or pregnancy events are an approximation. Don’t be overly alarmed if, in your pregnancy, they are off by a week or so.

OVERCOMING YOUR FEARS OF BEING A FATHER

You have a lot of time to get used to the idea of being a dad, so don’t worry if you have a lot of fears at first. Even if you aren’t sure you’re ready to become a father, you’ll be surprised how quickly you come around to the idea. Besides, the baby will be here before you know it, ready or not.

It’s important, however, to use this time to confront your fears about parenting. Spend time with the male role models from your past (and present) and use them as learning tools. Ask them what they did right, what they would change, and what advice they have for you when raising your own child. You may feel like you’re the first father ever, but you don’t need to reinvent the wheel when it comes to parenting. If you admire other people’s skills, monitor and mimic their behaviors.

Working on overcoming your fatherhood fears is doubly important if the father in your life wasn’t the best role model for the type of dad you want to be to your son or daughter. To attempt to come to terms with any wrongdoings your father may have committed, talk with a counselor or therapist, or even a trusted friend, about your relationship with your father and try to identify the mistakes you don’t want to repeat. Talking about your experience with your own father can also help heal some of the emotional wounds. Being a father is hard work, and you don’t want to wait until after the baby arrives to start overcoming your fears or past traumas.

Weeks 0 to 4

If you suspect that you’re pregnant, you’re probably both excited and anxious to find out if you truly are. The first four weeks are important because the pregnancy is getting established as the implantation process is underway.

During these initial weeks, do the following:

Record your last menstrual period. Doing so helps your provider better estimate your due date (40 weeks from your last period). Be sure to tell him if your cycles are irregular.

Begin taking a daily prenatal vitamin if you haven’t already. Check to see that the vitamin has at least 400 micrograms of folic acid to make sure your baby is as healthy as possible.

Check for ovulation. Some women know when they ovulate by a sensation known as mittelschmerz (German for middle pain, due to the mild pain that may be felt when the egg is released from the ovary, typically 14 days after your last period). Others know they’ve ovulated due to a change in the cervical mucus or a positive reading from an ovulation prediction kit.

Fertilization usually occurs within the fallopian tube. The embryo starts as one cell. During the 1st week, that cell divides many times as it moves down the fallopian tube toward the uterine cavity.

Take your first pregnancy test. As stated earlier, pregnancy tests check for a hormone called human chorionic gonadotropin (hCG), which is produced by the placenta as the embryo implants into the wall of the uterus — usually five to seven days after conception. By the time you miss a period, around ten days after conception, your pregnancy test will most likely be positive.

Don’t be too concerned if you have a little spotting around the time when you would expect your period. This is most likely due to the embryo implanting in the womb (implantation bleeding).

At the end of the 4th week, your baby measures 0.2 inches (5 mm) in length.

Weeks 5 to 8

By this time, the pregnancy is well established, and you’re feeling the typical signs and symptoms of pregnancy, such as nausea and fatigue. During weeks 5 to 8, most of the baby’s organ systems are beginning to form. The first organ to start working is the heart. It’s amazing to realize it starts beating at just 5 weeks, although you can’t see it beating on ultrasound until 6 weeks. The baby’s arms and legs are beginning to develop at this stage. The head is the biggest part of the embryo because the brain is the fastest-growing organ at this time. (Check out Chapter 1 in Book 2 for more on what happens during the first trimester.) The placenta is rapidly growing and is now the way nutrients and oxygen get to your developing baby.

This is an important time to make any necessary lifestyle changes, if you haven’t already done so (like stopping smoking or speaking with your doctor about adjusting medications — Book 1, Chapter 2 explains the effects of certain medications, alcohol, and drugs on the developing fetus). Also during this time, begin making these necessary medical appointments:

Call your doctor to make an appointment for your first prenatal visit. Most doctors want to see their patients before 8 to 10 weeks. Head to Book 1, Chapter 2 for advice on selecting a practitioner and what to expect during your prenatal visits.

Talk to your healthcare provider about scheduling an ultrasound or obtaining a heartbeat by Doppler to confirm a healthy pregnancy. An ultrasound during this period is very accurate at establishing your due date (it is sometimes called a dating scan) and can also tell you whether you’re having one, two, or even more babies! Your due date is most accurate when it is established by an ultrasound between 8 and 12 weeks.

If you’re taking any medications, call or see your doctor earlier than the 8 to 10 weeks mentioned. You want to make sure that these meds aren’t a problem for your developing baby. You should also discuss any over-the-counter or herbal medications you’re taking to make sure they aren’t a problem, either.

At the end of the 8th week, your baby measures 1.2 inches (3.0 cm) in length. Your uterus is about the size of a medium orange.

Weeks 9 to 12

Although you won’t be feeling it this early, this is the time when your baby starts to move around. If you’re having an ultrasound at this time, you may actually see these movements on the screen. Before 10 weeks, male and female embryos look the same. After 10 weeks, their external genitalia start to develop differently, although your practitioner may not be able to see this difference on ultrasound until after 16 to 20 weeks, depending on the position of the baby, the amount of abdominal tissue the sound waves have to pass through, the kinds of equipment used, and the experience of the person performing the ultrasound. By the end of the 10th week, all the organ systems have formed. The brain is unique in that it continues to develop throughout pregnancy and even into adulthood.

You want to consider the following counseling and testing at this time:

Schedule an appointment for genetic counseling if you have a family history of genetic problems. Your doctor may also recommend it, depending on varying circumstances.

Make sure you schedule your first-trimester screen for Down syndrome. Remember, the best time to screen for Down syndrome is at 11 to 12 weeks (see Book 2, Chapter 1 for detailed information about the first trimester and Down syndrome screening). This screen combines a measurement of the fluid-filled region behind the fetal neck (called a nuchal translucency), your age, and blood tests (hCG and PAPP-A) to give you a specific risk for Down syndrome as well as for Trisomy 13 and 18 (other chromosomal disorders).

Talk to your provider to see whether he thinks you’re a candidate for a newer type of screening for Down syndrome that extracts fetal genetic material from your blood. This blood sample can be drawn as early as 9 weeks.

If you’re considering having a chorionic villus sampling (CVS), weeks 10 to 12 are the best time to do this. This test can reveal chromosomal conditions as well as other genetic conditions, such as cystic fibrosis. See Book 2, Chapter 1 for more information on this test.

At the end of week 12, your baby is 2.13 inches (5.4 cm) long and weighs less than half an ounce (around 14 g). Your uterus is the size of a large orange.

Weeks 13 to 16

Congratulations! You and your baby made it through the first trimester. You’re starting to feel more like yourself — you have more energy and less nausea. After week 14, the majority of the amniotic fluid surrounding your baby is made up of the baby’s urine. By week 15, an experienced sonographer can tell by ultrasound whether you’re having a boy or a girl. By week 16, your baby starts to grow fine, soft hair (called lanugo) and fingernails.

The following considerations apply during this time period:

Between weeks 15 and 18, have your blood drawn to check the alpha-fetoprotein (AFP) level. This blood test helps to identify fetal abnormalities such as spina bifida. This is also the time to have the second part of your Down syndrome screening (the quad screen).