Results

First day of your last menstrual period: January 2, 2010 You most likely ovulated between: January 14, 2010 and January 16, 2010 If conception occurred: Your estimated due date is: Saturday, October 9, 2010 Your second trimester will begin: March 28, 2010 Your third trimester will begin: July 18, 2010

A missed period is often the first sign of pregnancy. You might have other body changes too, such as morning sickness and breast tenderness. If you think you could be pregnant, see your doctor to confirm your pregnancy. In the meantime, make sure you are getting 400 micrograms (400 mcg or 0.4 mg) of folic acid every day. A baby's vital organs begin to form in the first weeks of pregnancy sometimes before a woman even knows she is pregnant. Taking folic acid can help lower the chances of certain birth defects if you are pregnant. Learn more about your first trimester.

How ovulation is calculated

Your date of ovulation is calculated by subtracting 14 to 16 days from the date of your next period. This is an approximation and may not be exact for every woman. These calculations may not be accurate if your cycle is less than 21 days long or more than 35 days long, or if your menstrual cycle is irregular from month to month. Please consult your doctor for more detailed information. You are most likely to become pregnant if sexual activity occurs right before or after ovulation.
How your due date is calculated

Your due date is estimated by adding 40 weeks (280 days) to the approximate first day of your last menstrual period. Only 5 percent of women deliver their babies on their due date, so this date should be used as an estimate. It is not an exact calculation. Pregnancy lasts about 40 weeks, counting from the first day of your last normal period. The weeks are grouped into three trimesters (TREYE-mess-turs). Find out what's happening with you and your baby in these three stages.

First Trimester (Week 1-Week 12)

First Trimester

During the first trimester your body undergoes many changes. Hormonal changes affect almost every organ system in your body. These changes can trigger symptoms even in the very first weeks of pregnancy. Your period stopping is a clear sign that you are pregnant. Other changes may include:

See how your baby is growing inside of you during the first trimester.

Did you know? For some women, body image is a huge concern during pregnancy. Learn what you can do to accept and love your pregnant body in our Pregnancy and Body Image section.

Second Trimester

Extreme tiredness Tender, swollen breasts. Your nipples might also stick out. Upset stomach with or without throwing up (morning sickness) Cravings or distaste for certain foods Mood swings Constipation (trouble having bowel movements) Need to pass urine more often Headache Heartburn Weight gain or loss

As your body changes, you might need to make changes to your daily routine, such as going to bed earlier or eating frequent, small meals. Fortunately, most of these discomforts will go away as your pregnancy progresses. And some women might not feel any discomfort at all! If you have been pregnant before, you might feel differently this time around. Just as each woman is different, so is each pregnancy.
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Second Trimester (Week 13-Week 28)

Most women find the second trimester of pregnancy easier than the first. But it is just as important to stay informed about your pregnancy during these months. You might notice that symptoms like nausea and fatigue are going away. But other new, more noticeable changes to your body are now happening. Your abdomen will expand as the baby continues to grow. And before this trimester is over, you will feel your baby beginning to move! As your body changes to make room for your growing baby, you may have:

Body aches, such as back, abdomen, groin, or thigh pain Stretch marks on your abdomen, breasts, thighs, or buttocks Darkening of the skin around your nipples A line on the skin running from belly button to pubic hairline Patches of darker skin, usually over the cheeks, forehead, nose, or upper lip. Patches often match on both sides of the face. This is sometimes called the mask of pregnancy. Numb or tingling hands, called carpal tunnel syndrome Itching on the abdomen, palms, and soles of the feet. (Call your doctor if you have nausea, loss of appetite, vomiting, jaundice or fatigue combined with itching. These can be signs of a serious liver problem.) Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of preeclampsia.)
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See how your baby is growing inside of you during the third trimester.

Third Trimester (Week 29-Week 40)

You're in the home stretch! Some of the same discomforts you had in your second trimester will continue. Plus, many women find breathing difficult and notice they have to go to the bathroom even more often. This is because the baby is getting bigger and it is putting more pressure on your organs. Don't worry, your baby is fine and these problems will lessen once you give birth. Some new body changes you might notice in the third trimester include:

Shortness of breath Heartburn Swelling of the ankles, fingers, and face. (If you notice any sudden or extreme swelling or if you gain a lot of weight really quickly, call your doctor right away. This could be a sign of preeclampsia.) Hemorrhoids Tender breasts, which may leak a watery pre-milk called colostrum (kuh-LOSS-struhm) Your belly button may stick out Trouble sleeping The baby "dropping", or moving lower in your abdomen Contractions, which can be a sign of real or false labor

As you near your due date, your cervix becomes thinner and softer (called effacing). This is a normal, natural process that helps the birth canal (vagina) to open during the birthing process. Your doctor will check your progress with a vaginal exam as you near your due date. Get excited the final countdown has begun!
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Your Developing Baby

First Trimester (Week 1-Week 12) At 4 weeks: Your baby's brain and spinal cord have begun to form. The heart begins to form. Arm and leg buds appear.

Your baby is now an embryo and 1/25 of an inch long.

At 8 weeks: All major organs and external body structures have begun to form. Your baby's heart beats with a regular rhythm. The arms and legs grow longer, and fingers and toes have begun to form. The sex organs begin to form. The eyes have moved forward on the face and eyelids have formed. The umbilical cord is clearly visible.

At the end of 8 weeks, your baby is a fetus and looks more like a human. Your baby is nearly 1 inch long and weighs less than 1/8 of an ounce.

At 12 weeks: The nerves and muscles begin to work together. Your baby can make a fist. The external sex organs show if your baby is a boy or girl. A woman who has an ultrasound in the second trimester or later might be able to find out the baby's sex. Eyelids close to protect the developing eyes. They will not open again until the 28th week.

Head growth has slowed, and your baby is much longer. Now, at about 3 inches long, your baby weighs almost an ounce.
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Second Trimester (Week 13-Week 28) At 16 weeks: Muscle tissue and bone continue to form, creating a more complete skeleton. Skin begins to form. You can nearly see through it. Meconium (mih-KOHnee-uhm) develops in your baby's intestinal tract. This will be your baby's first bowel movement. Your baby makes sucking motions with the mouth (sucking reflex).

Your baby reaches a length of about 4 to 5 inches and weighs

almost 3 ounces.

At 20 weeks: Your baby is more active. You might feel slight fluttering. Your baby is covered by fine, downy hair called lanugo (luh-NOO-goh) and a waxy coating called vernix. This protects the forming skin underneath. Eyebrows, eyelashes, fingernails, and toenails have formed. Your baby can even scratch itself. Your baby can hear and swallow.

Now halfway through your pregnancy, your baby is about 6 inches long and weighs about 9 ounces.

At 24 weeks: Bone marrow begins to make blood cells. Taste buds form on your baby's tongue. Footprints and fingerprints have formed. Real hair begins to grow on your baby's head. The lungs are formed, but do not work. The hand and startle reflex develop. Your baby sleeps and wakes regularly. If your baby is a boy, his testicles begin to move

from the abdomen into the scrotum. If your baby is a girl, her uterus and ovaries are in place, and a lifetime supply of eggs have formed in the ovaries.

Your baby stores fat and has gained quite a bit of weight. Now at about 12 inches long, your baby weighs about 1 pounds.
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Third Trimester (Week 29-Week 40) At 32 weeks: Your baby's bones are fully formed, but still soft. Your baby's kicks and jabs are forceful. The eyes can open and close and sense changes in light. Lungs are not fully formed, but practice "breathing" movements occur. Your baby's body begins to store vital minerals, such as iron and calcium. Lanugo begins to fall off.

Your baby is gaining weight quickly, about pound a week. Now, your baby is about 15 to 17 inches long and weighs about 4 to 4 pounds.

At 36 weeks: The protective waxy coating called vernix gets thicker. Body fat increases. Your baby is getting bigger and bigger and has less space to move around. Movements are less forceful, but you will feel stretches and wiggles.

Your baby is about 16 to 19 inches long and weighs about 6 to 6 pounds.

Weeks 37-40: By the end of 37 weeks, your baby is considered full term. Your baby's organs are ready to function on their own. As you near your due date, your baby may turn into a head-down position for birth. Most babies "present" head down.

At birth, your baby may weigh somewhere between 6 pounds, 2 ounces and 9 pounds, 2 ounces and be 19 to 21 inches long. Most fullterm babies fall within these ranges. But healthy babies come in many different sizes.
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Additional Resources

Publications

1.

Pregnancy, Childbirth, and Bladder Control This publication looks at the effects that pregnancy and childbearing can have on bladder control and ways to counter the effects. http://kidney.niddk.nih.gov/kudiseases/pubs/pdf/pregnancy_ez.pdf

2. A Week-by-Week Pregnancy Calendar (Copyright Nemours Foundation) This illustrated pregnancy calendar is a detailed guide to all the changes taking place in your baby and in you! Each week of pregnancy includes a description of your baby's development, as well as an explanation of the changes taking place in your body. You'll also find important medical information that will help keep you and your baby healthy. http://www.kidshealth.org/parent/pregnancy_newborn/calendar/pregnancy_calen dar_intro.html... 3. How Your Baby Grows (Copyright MOD) This site provides information on the development of your baby and the changes in your body during each month of pregnancy. In addition, for each month it provides information on when to go for prenatal care appointments and general tips to take care of yourself and your baby. http://www.marchofdimes.com/aboutus/1808_2134.asp 4. Morning Sickness (Copyright AAFP) This publication discusses morning sickness, how long it will last, and how to help relieve morning sickness. http://familydoctor.org/online/famdocen/home/women/pregnancy/basics/154.html 5. Pregnancy and Your Emotions (Copyright Yale-New Haven Hospital) This fact sheet explains the normal emotions and concerns that occur during pregnancy and how to deal with issues such as work, sex, sleep, and anxiety. http://www.ynhh.com/maternity/concerns/your_emotions.html 6. Second Trimester Pregnancy: What to Expect (Copyright MFMER) This fact sheet discusses how the changes that began in the first weeks of pregnancy increase and accelerate during the second trimester. Of these, your growing uterus is probably the most obvious. But many other, unseen events are also taking place. http://www.mayoclinic.com/print/pregnancy/PR00018/METHOD=print 7. Taking Care of You and Your Baby While You're Pregnant (Copyright AAFP) This publication contains information on the importance of prenatal care, what

happens during doctor visits, how much weight should be gained during pregnancy, what you should eat, and also a list of do's and donts during pregnancy. http://familydoctor.org/online/famdocen/home/women/pregnancy/basics/053.html 8. Third Trimester Pregnancy: What to Expect (Copyright Mayo Foundation for Medical Education and Research) This fact sheet explains how at term or the third trimester, the uterus will weigh about 2 1/2 pounds (a little over one kilogram) and will have stretched to hold your baby, the placenta and about a quart (about a liter) of amniotic fluid. Nearly all of the physical symptoms of late pregnancy arise from this increase in the size of the uterus. http://www.mayoclinic.com/print/pregnancy/PR00009/METHOD=print 9. Weight Gain During Pregnancy (Copyright MOD) This brief fact sheet explains how much weight a woman should gain during pregnancy by explaining the different aspects of pregnancy that add to overall weight. http://www.marchofdimes.com/printableArticles/159_153.asp 10. Your Body Changes (Copyright Yale-New Haven Hospital) This fact sheet informs expecting mothers of the physical changes they may experience during pregnancy, and tips for coping with morning sickness, ligament pain, tender breasts, dizziness, varicose veins, hemorrhoids, leg cramps, swelling, backaches, constipation, heartburn, headache, and vaginal discharge. http://www.ynhh.com/maternity/concerns/body_changes.html

Prenatal Care and Tests

Home > Healthy Pregnancy > You're Pregnant: Now What? > Prenatal Care and Tests

Choosing a Prenatal Care Provider Places to Deliver Your Baby Prenatal Checkups Monitor Your Baby's Activity Prenatal Tests High-Risk Pregnancy Paying for Prenatal Care Additional Resources

Medical checkups and screening tests help keep you and your baby healthy during pregnancy. This is called prenatal care. It also involves education and counseling about how to handle different aspects of your pregnancy. During your visits, your doctor may

discuss many issues, such as healthy eating and physical activity, screening tests you might need, and what to expect during labor and delivery.

Choosing a Prenatal Care Provider

You will see your prenatal care provider many times before you have your baby. So you want to be sure that the person you choose has a good reputation, and listens to and respects you. You also will want to find out if the doctor or midwife can deliver your baby in the place you want to give birth, such as a specific hospital or birthing center.

Health care providers that care for women during pregnancy include:

What is a doula? A doula (DOO-luh) is a professional labor coach, who gives physical and emotional support to women during labor and delivery. They offer advice on breathing, relaxation, movement, and positioning. Doulas also give emotional support and comfort to women and their partners during labor and birth. Doulas and midwives often work together during a woman's labor. A recent study showed that continuous doula support during labor was linked to shorter labors and much lower use of:

pain medicines oxytocin (ok-seeTOHS-uhn) (medicine to help labor progress) cesarean delivery

Check with your health insurance company to find out if they will cover the cost of a doula. When choosing a doula, find out if she is certified by Doulas of North America (DONA) or another professional group.

Obstetricians (OB) are medical doctors who specialize in the care of pregnant women and in delivering babies. OBs also have special training in surgery so they are also able to do a cesarean delivery. Women who have health problems or are at risk for pregnancy complications should see an obstetrician. Women with the highest risk pregnancies might need special care from a maternal-fetal medicine specialist.

Family practice doctors are medical doctors who provide care for the whole family through all stages of life. This includes care during pregnancy and delivery, and following birth. Most family practice doctors cannot perform cesarean deliveries. A certified nurse-midwife (CNM) and certified professional midwife (CPM) are trained to provide pregnancy and postpartum care. Midwives can be a good option for healthy women at low risk for problems during pregnancy, labor, or delivery. A CNM is educated in both nursing and midwifery. Most CNMs practice in hospitals and birth centers. A CPM is required to have experience delivering babies in home settings because most CPMs practice in homes and birthing centers. All midwives should have a back-up plan with an obstetrician in case of a problem or emergency.

Ask your primary care doctor, friends, and family members for provider recommendations. When making your choice, think about:

Reputation Personality and bedside manner The provider's gender and age Office location and hours Whether you always will be seen by the same provider during office checkups and delivery Who covers for the provider when she or he is not available Where you want to deliver How the provider handles phone consultations and after-hour calls.

Places to Deliver Your Baby

Many women have strong views about where and how they'd like to deliver their babies. In general, women can choose to deliver at a hospital, birth center, or at home. You will need to contact your health insurance provider to find out what options are available. Also, find out if the doctor or midwife you are considering can deliver your baby in the place you want to give birth.

Hospitals are a good choice for women with health problems, pregnancy complications, or those who are at risk for problems during labor and delivery. Hospitals offer the most advanced medical equipment and highly trained doctors for pregnant women and their babies. In a hospital, doctors can do a cesarean delivery if you or your baby is in danger during labor. Women can get epidurals or many other pain relief options. Also, more and more hospitals now offer on-site birth centers, which aim to offer a style of care similar to standalone birth centers.

Did you know? Some hospitals and birth centers have taken special steps to create the best possible environment for successful breastfeeding. They are called BabyFriendly Hospitals and Birth Centers. Women who deliver in a babyfriendly facility are promised the information and support they need to breastfeed their infants. Learn more about BabyFriendly Hospitals.

Questions to ask when choosing a hospital:

o o o o o o o o

Is it close to your home? Is a doctor who can give pain relief, such as an epidural, at the hospital 24-hours a day? Do you like the feel of the labor and delivery rooms? Are private rooms available? How many support people can you invite into the room with you? Does it have a neonatal intensive care unit (NICU) in case of serious problems with the baby? Can the baby stay in the room with you? Does it have an on-site birth center?

Birth or Birthing Centers give women a "homey" environment in which to labor and give birth. They try to make labor and delivery a natural and personal process by doing away with most high-tech equipment and routine procedures. So, you will not automatically be hooked up to an IV. Likewise, you won't have an electronic fetal monitor around your belly the whole time. Instead, the midwife or nurse will check in on your baby from time to time with a handheld machine. Once the baby is born, all exams and care will occur in your room. Usually certified nurse-midwives, not obstetricians, deliver babies at birth centers. Healthy women who are at low risk for problems during pregnancy, labor, and delivery may choose to deliver at a birth center. Women can not receive epidurals at a birth center, although some pain medicines may be available. If a cesarean delivery becomes necessary, women must be moved to a hospital for the procedure. After delivery, babies with problems can receive basic emergency care while being moved to a hospital.

Many birthing centers have showers or tubs in their rooms for laboring women. They also tend to have comforts of home like large beds and rocking chairs. In general, birth centers allow more people in the delivery room than do hospitals. Birth centers can be inside of hospitals, a part of a hospital or completely separate facilities. If you want to deliver at a birth center, make sure it meets the standards of the Accreditation Association for Ambulatory Health Care, The Joint Commission, or the American Association of Birth Centers. Accredited birth centers must have doctors who can work at a nearby hospital in case of problems with the mom or baby.

Homebirth is an option for healthy pregnant women with no risk factors for complications during pregnancy, labor or delivery. It is also important women have a strong after-care support system at home. Some certified nurse midwives and doctors will deliver babies at home. Many health insurance companies do not cover the cost of care for homebirths. So check with your plan if you'd like to deliver at home. Homebirths are common in many countries in Europe. But in the United States, planned homebirths are not supported by the American College of Obstetricians and Gynecologists (ACOG). ACOG states that hospitals are the safest place to deliver a baby. In case of an emergency, says ACOG, a hospital's equipment and highly trained doctors can provide the best care for a woman and her baby. If you are thinking about a homebirth, you need to weigh the pros and cons. The main advantage is that you will be able to experience labor and delivery in the privacy and comfort of your own home. Since there will be no routine medical procedures, you will have control of your experience. The main disadvantage of a homebirth is that in case of a problem, you and the baby will not have immediate hospital/medical care. It will have to wait until you are transferred to the hospital. Plus, women who deliver at home have no options for pain relief. To ensure your safety and that of your baby, you must have a highly trained and experienced midwife along with a fail-safe back-up plan. You will need fast, reliable transportation to a hospital. If you live far away from a hospital, homebirth may not be the best choice. Your midwife must be experienced and have the necessary skills and supplies to start emergency care for you and your baby if need be. Your midwife should also have access to a doctor 24 hours a day.
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Prenatal Checkups

During pregnancy, regular check-ups are very important. This consistent care can help keep you and your baby healthy, spot problems if they occur, and prevent problems during delivery. Typically, routine checkups occur:

once each month for weeks 4 through 28 twice a month for weeks 28 through 36 weekly for weeks 36 to birth

Women with high-risk pregnancies need to see their doctors more often. At your first visit your doctor will perform a full physical exam, take your blood for lab tests, and calculate your due date. Your doctor might also do a breast exam, a pelvic exam to check your uterus (womb), and a cervical exam, including a Pap test. During this first visit, your doctor will ask you lots of questions about your lifestyle, relationships, and health habits. It's important to be honest with your doctor. After the first visit, most prenatal visits will include:

checking your blood pressure and weight checking the baby's heart rate measuring your abdomen to check your baby's growth

You also will have some routine tests throughout your pregnancy, such as tests to look for anemia, tests to measure risk of gestational diabetes, and tests to look for harmful infections. Become a partner with your doctor to manage your care. Keep all of your appointments every one is important! Ask questions and read to educate yourself about this exciting time.
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Monitor Your Baby's Activity

After 28 weeks, keep track of your baby's movement. This will help you to notice if your baby is moving less than normal, which could be a sign that your baby is in distress and needs a doctor's care. An easy way to do this is the Count-to-Ten approach. Count your baby's movements in the evening the time of day when the fetus tends to be most active. Lie down if you have trouble feeling your baby move. Most women count 10 movements within about 20 minutes. Count your baby's movements every day so you know what is normal for you. Call your doctor if you count less than 10 movements within 2 hours.
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Prenatal Tests

Tests are used during pregnancy to check your and your baby's health. At your fist prenatal visit, your doctor will use tests to check for a number of things, such as:

Avoid keepsake ultrasounds You might think a keepsake ultrasound is a must-have for your scrapbook. But, doctors advise against ultrasound when there is no medical need to do so. Some companies sell "keepsake" ultrasound videos and images. Although ultrasound is considered safe for medical purposes, exposure to ultrasound energy for a keepsake video or image may put a mother and her unborn baby at risk. Don't take that chance.

Your blood type and Rh factor Anemia Infections, such as toxoplasmosis and sexually transmitted infections (STIs), including hepatitis B, syphilis, chlamydia, and HIV Signs that you are immune to rubella (German measles) and chicken pox

Throughout your pregnancy, your doctor or midwife may suggest a number of other tests, too. Some tests are suggested for all women, such as screenings for gestational diabetes, Down syndrome, and HIV. Other tests might be offered based on your:

Age Personal or family health history Ethnic background Results of routine tests

Some tests are screening tests. They detect risks for or signs of possible health problems in you or your baby. Based on screening test results, your doctor might suggest diagnostic tests. Diagnostic tests confirm or rule out health problems in you or your baby. The following chart describes some of the most common prenatal tests:
Common Prenatal Tests

Test

What It Is

How It Is Done

Amniocentesis (AM- This test can diagnosis certain birth nee-oh-sen-TEEdefects, including: suhss)

Down syndrome Cystic fibrosis Spina bifida

A thin needle is used to draw out a small amount of amniotic fluid and cells from the sac surrounding the fetus. The sample is sent to a lab for testing.

It is performed at 14 to 20 weeks. It may be suggested for couples at higher risk for genetic disorders. It also provides DNA for paternity testing.
Biophysical profile (BPP)

This test is used in the third trimester to monitor the overall health of the baby and to help decide if the baby should be delivered early.

BPP involves an ultrasound exam along with a nonstress test. The BPP looks at the baby's breathing, movement, muscle tone, heart rate, and the amount of amniotic fluid.
A needle removes a small sample of cells from the placenta to be tested.

Chorionic villus (KOR-ee-ON-ihk VIL-uhss) sampling (CVS)

A test done at 10 to 13 weeks to diagnose certain birth defects, including:

Chromosomal disorders, including Down syndrome Genetic disorders, such as cystic fibrosis

CVS may be suggested for couples at higher risk for genetic disorders. It also provides DNA for paternity testing.
First trimester screen

A screening test done at 11 to 14 weeks to detect higher risk of:

Chromosomal disorders, including Down syndrome and trisomy 18 Others problems, such as heart

This test involves both a blood test and an ultrasound exam called nuchal translucency (NOOkuhl trans-LOO-sent-see) screening. The blood test measures the levels of certain substances in the

defects

Based on test results, your doctor may suggest other tests to diagnose a disorder.

mother's blood. The ultrasound exam measures the thickness at the back of the baby's neck. This information, combined with the mother's age, help doctors determine risk to the fetus.
First, you consume a special sugary drink from your doctor. A blood sample is taken one hour later to look for high blood sugar levels.

Glucose challenge screening

A screening test done at 26 to 28 weeks to determine the mother's risk of gestational diabetes. Based on test results, your doctor may suggest a glucose tolerance test.

Glucose tolerance test

This test is done at 26 to 28 weeks to Your doctor will tell you diagnose gestational diabetes. what to eat a few days before the test. Then, you cannot eat or drink anything but sips of water for 14 hours before the test. Your blood is drawn to test your "fasting blood glucose level." Then, you will consume a sugary drink. Your blood will be tested every hour for 3 hours to see how well your body processes sugar. This test is done at 36 to 37 weeks to A swab is used to take cells look for bacteria that can cause from your vagina and pneumonia or serious infection in rectum to be tested. newborn. A screening test done at 15 to 20 weeks to detect higher risk of:

Group B streptococcus (STREP-tuh-KOKuhss) infection Maternal serum screen (also called quad screen, triple test, triple screen, multiple marker screen, or AFP)

Chromosomal disorders, including Down syndrome and trisomy 18 Neural tube defects, such as spina bifida

Blood is drawn to measure the levels of certain substances in the mother's blood.

It also can reveal multiple births.

Based on test results, your doctor may suggest other tests to diagnose a disorder.
Nonstress test (NST)

This test is performed after 28 weeks to monitor your baby's health. It can show signs of fetal distress, such as your baby not getting enough oxygen. An ultrasound exam can be performed at any point during the pregnancy. Ultrasound exams are not routine. But it is not uncommon for women to have a standard ultrasound exam between 18 and 20 weeks to look for signs of problems with the baby's organs and body systems and confirm the age of the fetus and proper growth. It also might be able to tell the sex of your baby. Ultrasound exam is also used as part of the first trimester screen and biophysical profile (BPP). Based on exam results, your doctor may suggest other tests or other types of ultrasound to help detect a problem.

A belt is placed around the mother's belly to measure the baby's heart rate in response to its own movements. Ultrasound uses sound waves to create a "picture" of your baby on a monitor. With a standard ultrasound, a gel is spread on your abdomen. A special tool is moved over your abdomen, which allows your doctor and you to view the baby on a monitor.

Ultrasound exam

Urine test

A urine sample can look for signs of health problems, such as:

Urinary tract infection Diabetes Preeclampsia

If your doctor suspects a problem, the sample might be sent to a lab for more in-depth testing.

You will collect a small sample of clean, midstream urine in a sterile plastic cup. Testing strips that look for certain substances in your urine are dipped in the sample. The sample also can be looked at under a microscope.

Understanding Prenatal Tests and Test Results

If your doctor suggests certain prenatal tests, don't be afraid to ask lots of questions. Learning about the test, why your doctor is suggesting it for you, and what the test results could mean can help you cope with any worries or fears you might have. Keep in mind that screening tests do not diagnose problems. They evaluate risk. So if a screening test comes back abnormal, this doesn't mean there is a problem with your baby. More information is needed. Your doctor can explain what test results mean and possible next steps.
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High-Risk Pregnancy
Pregnancies with a greater chance of complications are called "high-risk." But this doesn't mean there will be problems. The following factors may increase the risk of problems during pregnancy:

Very young age or older than 35 Overweight or underweight Problems in previous pregnancy Health conditions you have before you become pregnant, such as high blood pressure, diabetes, autoimmune disorders, cancer, and HIV Pregnancy with twins or other multiples

Health problems also may develop during a pregnancy that make it high-risk, such as gestational diabetes or preeclampsia. See Problems During Pregnancy. Women with high-risk pregnancies need prenatal care more often and sometimes from a specially trained doctor. A maternal-fetal medicine specialist is a medical doctor that cares for high-risk pregnancies. If your pregnancy is considered high risk, you might worry about your unborn baby's health and have trouble enjoying your pregnancy. Share your concerns with your doctor. Your doctor can explain your risks and the chances of a real problem. Also, be sure to follow your doctor's advice. For example, if your doctor tells you to take it easy, then ask your partner, family members, and friends to help you out in the months ahead. You will feel better knowing that you are doing all you can to care for your unborn baby.
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Paying for Prenatal Care

Pregnancy can be stressful if you are worried about affording health care for you and your unborn baby. For many women, the extra expenses of prenatal care and preparing for the new baby are overwhelming. The good news is that women in every state can

get help to pay for medical care during their pregnancies. Every state in the United States has a program to help. Programs give medical care, information, advice, and other services important for a healthy pregnancy. To find out about the program in your state:

Call 1-800-311-BABY (1-800-311-2229) This toll-free telephone number will connect you to the Health Department in your area code. Call 1-800-504-7081 for information in Spanish. Call or contact your local Health Department.

You may also find help through these places:

Local hospital or social service agencies Ask to speak with a social worker on staff. She or he will be able to tell you where to go for help. Community clinics Some areas have free clinics or clinics that provide free care to women in need. Women, Infants and Children (WIC) Program This government program is available in every state. It provides help with food, nutritional counseling, and access to health services for women, infants, and children. Places of worship
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Additional Resources
Publications

1.

Fact Sheet Pregnancy and Medications This fact sheet provides information on the safety of using medications while pregnant. http://www.womenshealth.gov/faq/pregnancy-medicines.cfm

2.

Folic Acid: Questions and Answers The purpose of this question and answer sheet is to educate women of childbearing age on the importance of consuming 400 micrograms of folic acid every day. This, in turn, will reduce the risk of spina bifida by 50 to 70 percent. http://www.cdc.gov/ncbddd/folicacid/faqs.html

3.

For Women with Diabetes: Your Guide to Pregnancy This booklet discusses pregnancy in women with diabetes. If you have type 1 or type 2 diabetes and you are pregnant or hoping to get pregnant soon, you can learn what to do to have a healthy baby. You can also learn how to take care of yourself and your diabetes before, during, and after your pregnancy. http://www.diabetes.niddk.nih.gov/dm/pubs/pregnancy/

4.

General Information About Pregnancy Exposure Registries Pregnancy registries help women make informed and educated decisions about using medicines during pregnancy. If you are pregnant and currently taking medicine or have been exposed to a medicine during your pregnancy you may be able to participate and help in the collection of this information. This Web site provides a list of pregnancy registries that are enrolling pregnant women. http://www.fda.gov/ScienceResearch/SpecialTopics/WomensHealthResearch/uc m134844.htm...

5.

Genetics Home Reference This Web site provides information on specific genetic conditions and the genes or chromosomes responsible for these conditions. http://ghr.nlm.nih.gov/

6.

Guidelines for Vaccinating Pregnant Women This publication provides information on routine and other vaccines and whether they are recommended for use during pregnancy. http://www.cdc.gov/vaccines/pubs/preg-guide.htm

7.

HIV Testing and Pregnancy This publication provides information on HIV testing during pregnancy, the benefits of being tested, and where to go to learn about HIV testing policies in your state. http://www.aidsinfo.nih.gov/ContentFiles/HIVTestingandPregnancy_FS_en.pdf

8.

MyPyramid for Pregnancy & Breastfeeding When you are pregnant or breastfeeding, you have special nutritional needs. This section of MyPyramid.gov is designed just for you. It has advice you need to help you and your baby stay healthy. http://www.mypyramid.gov/mypyramidmoms/index.html

9.

Pregnancy and Bone Health This publication contains information on pregnancy-associated osteoporosis, lactation and bone loss, and what you can do to keep your bones healthy during these stages of your life. http://www.niams.nih.gov/Health_Info/Bone/Bone_Health/Pregnancy/default.asp

10.

Pregnancy Information Center, CDC If you're pregnant or planning to get pregnant, you probably have a lot of questions. This web site will help you learn how to be healthy (before, during, and after pregnancy) and give your baby a healthy start to life.

http://www.cdc.gov/ncbddd/pregnancy_gateway/default.htm 11. Preventing Infections During Pregnancy These 10 tips can help you prevent infections that could harm your unborn baby. You wont always know if you have an infectionsometimes you wont even feel sick. If you think you might have an infection or think you are at risk, see your doctor. http://www.cdc.gov/Features/pregnancy/ 12. Safe Motherhood: Promoting Health for Women Before, During and After Pregnancy This report emphasizes the importance of proper care from conception through delivery, in order to prevent complications when possible. The ideal result is a labor at term without any unnecessary interventions. http://www.cdc.gov/nccdphp/publications/aag/pdf/drh.pdf 13. A Week-by-Week Pregnancy Calendar (Copyright Nemours Foundation) This illustrated pregnancy calendar is a detailed guide to all the changes taking place in your baby and in you! Each week of pregnancy includes a description of your baby's development, as well as an explanation of the changes taking place in your body. You'll also find important medical information that will help keep you and your baby healthy. http://www.kidshealth.org/parent/pregnancy_newborn/calendar/pregnancy_calen dar_intro.html... 14. Chorionic Villus Sampling (CVS) (Copyright MOD) Chorionic villus sampling (CVS) is a prenatal test that can diagnose or rule out certain birth defects. The test is generally performed between 10 and 12 weeks after a woman's last menstrual period. This fact sheet provides information about this test, and how the test sample is taken. http://www.marchofdimes.com/professionals/14332_1165.asp 15. Folic Acid Fact Sheet (Copyright MOD) This fact sheet stresses the importance of getting higher amounts of folic acid during pregnancy in order to prevent neural tube defects in unborn children. http://www.marchofdimes.com/pnhec/173_769.asp 16. Good Health Before Pregnancy: Preconception Care (Copyright ACOG) This publication discusses preconception care, which includes planning your pregnancy and talking to your doctor about your family history, medical history, past pregnancies, medications, and lifestyle. http://www.acog.org/publications/patient_education/bp056.cfm

17. Health Insurance for Pregnancy, Labor and Birth (Copyright Great Starts) This article lists the questions you should ask your health insurance provider before you get pregnant or once you know you are pregnant. It also provides information on how to switch insurance during pregnancy, what government assistance programs are available if you don't have health insurance, and what other health care options are available. http://www.greatstarts.org/articles_newsletter/feature/insurance.htm 18. HIV and Other Important Pregnancy Tests (Copyright ACOG) This tear pad explains how to be tested for HIV, what happens with your HIV test results and it offers helpful treatments for you and your baby. http://www.acog.org/bookstore/HIV_and_Other_Important_Pregna_P208.cfm 19. How Your Baby Grows (Copyright MOD) This site provides information on the development of your baby and the changes in your body during each month of pregnancy. In addition, for each month it provides information on when to go for prenatal care appointments and general tips to take care of yourself and your baby. http://www.marchofdimes.com/aboutus/1808_2134.asp 20. Medical Care During Pregnancy (Copyright Nemours Foundation) This online resource contains information about receiving prenatal care before getting pregnant including information on finding medical care, medical visits and tests, common concerns, taking care of yourself and talking to your doctor. http://www.kidshealth.org/parent/pregnancy_newborn/pregnancy/medical_care_p regnancy.html... 21. Newborn Screening Tests (Copyright MOD) This fact sheet provides information about some of the disorders that newborns are tested for shortly after birth. http://www.marchofdimes.com/pnhec/298_834.asp 22. Pregnancy: Are X-rays Safe During Pregnancy? (Copyright AAFP) This fact sheet answers commonly asked questions about x-ray safety during pregnancy. It describes the level of radiation that is considered safe for a baby and what a woman can do instead of having an x-ray. http://familydoctor.org/online/famdocen/home/women/pregnancy/fetal/373.html 23. Prenatal Care: What to Expect During the First Trimester (Copyright MFMER) This fact sheet explains what to expect during routine exams with your doctor.

In addition, if you have a condition that makes your pregnancy high-risk, special tests may be performed on a regular basis to check the baby's health. http://www.mayoclinic.com/print/prenatal-care/PR00008/METHOD=print 24. Prenatal Diagnosis: Amniocentesis and CVS (Copyright AAFP) This handout provides a general overview of amniocentesis and chorionic villus sampling (CVS): two tests that can be done to check the status of the fetus. http://familydoctor.org/online/famdocen/home/women/pregnancy/fetal/144.html 25. Prenatal Tests (Copyright Nemours Foundation) This on-line resource offers information about prenatal tests that are preformed during pregnancy including, why prenatal tests are preformed, what do prenatal tests find, who needs prenatal tests, routine prenatal tests, chart of prenatal tests, talking to your doctor about prenatal tests and preventing birth defects. http://kidshealth.org/parent/pregnancy/pregnancy/prenatal_tests.html 26. Routine Tests During Pregnancy (Copyright ACOG) This on-line publication provides information about the different types of tests that are done during pregnancy. It also explains why and when the tests are conducted as well as any other tests that may be needed. http://www.medem.com/?q=medlib/article/ZZZ84JKXODC 27. Taking Care of You and Your Baby While You're Pregnant (Copyright AAFP) This publication contains information on the importance of prenatal care, what happens during doctor visits, how much weight should be gained during pregnancy, what you should eat, and also a list of do's and donts during pregnancy. http://familydoctor.org/online/famdocen/home/women/pregnancy/basics/053.html 28. Ten Tips for a Healthy Pregnancy (Copyright Lamaze International) This easy-to-read fact sheet provides 10 simple recommendations to help mothers ensure that they have a healthy pregnancy. http://www.lamaze.org/ExpectantParents/PregnancyandBirthResources/MoreTip sandTools/HealthyPregnancy/tabid/2... 29. Ultrasound (Copyright MOD) This fact sheet discusses the use of an ultrasound in prenatal care at each trimester. http://www.marchofdimes.com/printableArticles/159_523.asp

Pregnancy Complications
Home > Healthy Pregnancy > You're Pregnant: Now What? > Pregnancy Complications

Health Problems Before Pregnancy Pregnancy Related Problems Infections During Pregnancy When to Call the Doctor Additional Resources

Complications of pregnancy are health problems that occur during pregnancy. They can involve the mother's health, the baby's health, or both. Some women have health problems before they become pregnant that could lead to complications. Other problems arise during the pregnancy. Keep in mind that whether a complication is common or rare, there are ways to manage problems that come up during pregnancy.

Health Problems Before Pregnancy

If you have an ongoing health problem, make sure to talk to your doctor before pregnancy. Your doctor might want to change the way your health problem is managed. Some medicines used to treat health problems could be harmful if taken during pregnancy. At the same time, stopping medicines that you need could be more harmful then the risks posed should you become pregnant. Be assured that you are likely to have a normal, healthy baby when health problems are under control and you get good prenatal care.
Health Problems Before Pregnancy

Condition

How it can affect pregnancy

Where to learn more

Asthma

Poorly controlled asthma may increase risk of preeclampsia, poor weight gain in the fetus, preterm birth, cesarean birth, and other complications. Depression that persists during pregnancy can make it hard for a woman to care for herself and her unborn baby. Having depression before pregnancy also is a risk factor for postpartum depression. High blood glucose (sugar) levels during

Lung Diseases FAQ

Depression

Depression FAQ Depression During and After Pregnancy FAQ

Diabetes

Diabetes FAQ

pregnancy can harm the fetus and worsen a woman's long-term diabetes complications. Doctors advise getting diabetes under control at least 3 to 6 months before trying to conceive. Eating disorders Body image changes during pregnancy can cause eating disorders to worsen. Eating disorders are linked to many pregnancy complications, including birth defects and premature birth. Women with eating disorders also have higher rates of postpartum depression. Seizures during pregnancy can harm the fetus, and increase the risk of miscarriage or stillbirth. But using medicine to control seizures might cause birth defects. For most pregnant women with epilepsy, using medicine poses less risk to their own health and the health of their babies than stopping medicine. Having chronic high blood pressure puts a pregnant woman and her baby at risk for problems. Women with high blood pressure have a higher risk of preeclampsia and placental abruption (when the placenta separates from the wall of the uterus). The likelihood of preterm birth and low birth weight also is higher. HIV can be passed from a woman to her baby during pregnancy or delivery. Some HIV medicines can lower the chances of HIV being passed to the baby. But the effects of some medicines on the fetus are not clear or not known. Good prenatal care will help protect a woman's baby from HIV and keep her

Anorexia Nervosa FAQ Bulimia Nervosa FAQ

Epilepsy and other seizure disorders

About Epilepsy

High blood pressure

National High Blood Pressure Education Program

HIV

Women and HIV/AIDS

healthy. Migraine Migraine symptoms tend to improve during pregnancy. Some women have no migraine attacks during pregnancy. Certain medicines commonly used to treat headaches should not be used during pregnancy. A woman who has severe headaches should speak to her doctor about ways to relieve symptoms safely. Recent studies suggest that the heavier a woman is before she becomes pregnant, the greater her risk of a range of pregnancy complications, including preeclampsia and preterm delivery. Overweight and obese women who lose weight before pregnancy are likely to have healthier pregnancies. Some STIs can cause early labor, a woman's water to break too early, and infection in the uterus after birth. Some STIs also can be passed from a woman to her baby during pregnancy or delivery. Some ways STIs can harm the baby include: low birth weight, dangerous infections, brain damage, blindness, deafness, liver problems, or stillbirth. Uncontrolled hyperthyroidism (overactive thyroid) can be dangerous to the mother and cause health problems such as heart failure and poor weight gain in the fetus. Uncontrolled hypothyroidism (underactive thyroid) also threatens the mother's health and can lead to intellectual disabilities in the baby.

Migraine FAQ

Overweight and Obesity

Overweight, Obesity, and Weight Loss FAQ

Sexually transmitted infections (STIs)

Sexually Transmitted Infections FAQ

Thyroid disease

Graves' Disease FAQ Hashimoto's Thyroiditis FAQ

Uterine fibroids

Uterine fibroids are not uncommon, but few cause symptoms that require treatment. Uterine fibroids rarely cause miscarriage. Sometimes, fibroids can cause preterm or breech birth. Cesarean delivery may be needed if a fibroid blocks the birth canal.

Uterine Fibroids FAQ

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Related information Depression During and After Pregnancy FAQ

Pregnancy Related Problems

Sometimes pregnancy problems arise even in healthy women. Some prenatal tests done during pregnancy can help prevent these problems or spot them early. Use this chart to learn about some common pregnancy complications. Call your doctor if you have any of the symptoms on this chart. If a problem is found, make sure to follow your doctor's advice about treatment. Doing so will boost your chances of having a safe delivery and a strong, healthy baby.
Health Problems During Pregnancy

Problem

Symptoms

Treatment

Anemia Lower than normal number of healthy red blood cells

Feel tired or weak Look pale Feel faint Shortness of breath

Treating the underlying cause of the anemia will help restore the number of healthy red blood cells. Women with pregnancy related anemia are helped by taking iron and folic acid supplements. Your doctor will check your iron levels throughout pregnancy to be sure anemia does not happen again.

Depression Extreme sadness during pregnancy or after birth (postpartum)

Intense sadness Helplessness and irritability Appetite changes Thoughts of harming self or baby

Women who are pregnant might be helped with one or a combination of treatment options, including:

Therapy Support groups Medicines

A mother's depression can affect her baby's development, so getting treatment is important for both mother and baby. Ectopic (ek-TOP-ihk) pregnancy When a fertilized egg implants outside of the uterus, usually in the fallopian tube Fetal problems Unborn baby has a health issue, such as poor growth or heart problems

Abdominal pain Shoulder pain Vaginal bleeding Feeling dizzy or faint Baby moving less Baby is smaller than normal for gestational age Fewer than 10 kicks per day after 26 weeks Some problems have no symptoms, but are found with prenatal tests

With ectopic pregnancy, the egg cannot develop. Drugs or surgery is used to remove the ectopic tissue so your organs are not damaged.

Treatment depends on results of tests to monitor baby's health. If a test suggests a problem, this does not always mean the baby is in trouble. It may only mean that the mother needs special care until the baby is delivered. This can include a wide variety of things, such as bed rest, depending on the mother's condition. Sometimes, the baby has to be delivered early. Most women with pregnancy related diabetes can control their blood sugar levels by a following a healthy meal plan from their doctor. Some women also need insulin to keep blood sugar levels under control.

Gestational diabetes Too high blood sugar levels during pregnancy

Usually, there are no symptoms. Sometimes, extreme thirst, hunger, or fatigue Screening test shows high blood

sugar levels

Doing so is important because poorly controlled diabetes increases the risk of:

Preeclampsia Early delivery Cesearean birth Having a big baby, which can complicate delivery Baby born with low blood sugar, breathing problems, and jaundice

High blood pressure (pregnancy related) High blood pressure that starts after 20 weeks of pregnancy and goes away after birth Hyperemesis gravidarum (HEYEpur-EM-uh-suhss grav-uh-DAR-uhm) (HG) Severe, persistent nausea and vomiting during pregnancy more extreme than "morning sickness"

High blood pressure without other signs and symptoms of preeclampsia

The health of the mother and baby are closely watched to make sure high blood pressure is not preeclampsia.

Nausea that does not go away Vomiting several times every day Weight loss Reduced appetite Dehydration Feeling faint or fainting

Dry, bland foods and fluids is the first line of treatment. Sometimes, medicines are prescribed to help nausea. Many women with HG have to be hospitalized so they can be fed fluids and nutrients through a tube in their veins. Usually, women with HG begin to feel better by the 20th week of pregnancy. But some women vomit and feel nauseated throughout all three trimesters. In most cases, miscarriage cannot be prevented. Sometimes, a woman must undergo treatment to remove pregnancy tissue in the uterus. Counseling can help with emotional healing. See our

Miscarriage Pregnancy loss from natural causes before 20 weeks. As many as 20 percent of pregnancies end in miscarriage. Often,

Signs of a miscarriage can include:

Vaginal spotting or bleeding* Cramping or abdominal pain

miscarriage occurs before a woman even knows she is pregnant

Fluid or tissue passing from the vagina

section on Pregnancy Loss.

*Spotting early in pregnancy doesn't mean miscarriage is certain. Still, contact your doctor right away if you have any bleeding. Placenta previa Placenta covers part or entire opening of cervix inside of the uterus

Painless vaginal bleeding during second or third trimester For some, no symptoms

If diagnosed after the 20th week of pregnancy, but with no bleeding, a woman will need to cut back on her activity level and increase bed rest. If bleeding is heavy, hospitalization may be needed until mother and baby are stable. If the bleeding stops or is light, continued bed rest is resumed until baby is ready for delivery. If bleeding doesn't stop or if preterm labor starts, baby will be delivered by cesarean. When the separation is minor, bed rest for a few days usually stops the bleeding. Moderate cases may require complete bed rest. Severe cases (when more than half of the placenta separates) can require immediate medical attention and early delivery of the baby. The only cure is delivery, which may not be best for the baby. Labor will probably be induced if condition is mild and the woman is near term (37 to 40

Placental abruption Placenta separates from uterine wall before delivery, which can mean the fetus doesn't get enough oxygen.

Vaginal bleeding Cramping, abdominal pain, and uterine tenderness

Preeclampsia (preeee-CLAMP-see-uh) A condition starting after 20 weeks of pregnancy that causes

High blood pressure Swelling of hands and face Too much protein in urine

high blood pressure and problems with the kidneys and other organs. Also called toxemia.

Stomach pain Blurred vision Dizziness Headaches

weeks of pregnancy). If it is too early to deliver, the doctor will watch the health of the mother and her baby very closely. She may need medicines and bed rest at home or in the hospital to lower her blood pressure. Medicines also might be used to prevent the mother from having seizures. Medicines can stop labor from progressing. Bed rest is often advised. Sometimes, a woman must deliver early. Giving birth before 37 weeks is called "preterm birth."

Preterm labor Going into labor before 37 weeks of pregnancy

Increased vaginal discharge Pelvic pressure and cramping Back pain radiating to the abdomen Contractions

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Infections During Pregnancy

During pregnancy, your baby is protected from many illnesses, like the common cold or a passing stomach bug. But some infections can be harmful to your pregnancy, your baby, or both. This chart provides an overview of infections that can be harmful during pregnancy. Learn the symptoms and what you can do to keep healthy. Easy steps, such as hand washing, practicing safe sex, and avoiding certain foods, can help protect you from some infections.
Infections During Pregnancy

Infection

Symptoms

Prevention and treatment

Bacterial vaginosis (BV) A vaginal infection that is caused by an overgrowth of bacteria normally found in the

Grey or whitish discharge that has a foul, fishy odor Burning when passing urine or itching Some women

How to prevent BV is unclear. BV is not passed through sexual contact, although it is linked with having a new or more than one sex partner. Women with symptoms should

vagina. BV has been linked to preterm birth and lowbirth-weight babies. Cytomegalovirus (SEYE-toh-MEG-uhloh VEYE-ruhss) (CMV) A common virus that can cause disease in infants whose mothers are infected with CMV during pregnancy. CMV infection in infants can lead to hearing loss, vision loss, and other disabilities. Group B strep (GBS) Group B strep is a type of bacteria often found in the vagina and rectum of healthy women. One in 4 women has it. GBS usually is not harmful to you, but can be deadly to your baby if passed during childbirth.

have no symptoms

be tested for BV. Antibiotics are used to treat BV.

Mild illness that may include fever, sore throat, fatigue, and swollen glands Some women have no symptoms

Good hygiene is the best way to keep from getting CMV. No treatment is currently available. But studies are looking at antiviral drugs for use in infants. Work to create a CMV vaccine also is underway.

No symptoms

You can keep from passing GBS to your baby by getting tested at 35 to 37 weeks. This simply involves swabbing the vagina and rectum and does not hurt. If you have GBS, an antibiotic given to you during labor will protect your baby from infection. Make sure to tell the labor and delivery staff that you are a group B strep carrier when you check into the hospital.

Hepatitis B virus (HBV) A viral infection that can be passed to baby

There may be no symptoms. Or symptoms can include:

Lab tests can find out if the mother is a carrier of hepatitis B. You can protect your baby for

Nausea,

during birth. Newborns that get infected have a 90 percent chance of developing lifelong infection. This can lead to liver damage and liver cancer.

vomiting, and diarrhea Dark urine and pale bowel movements Whites of eyes or skin looks yellow

life from HBV with the hepatitis B vaccine, which is a series of 3 shots:

First dose of hepatitis B vaccine plus HBIG shot given to baby at birth Second dose of hepatitis B vaccine given to baby at 1-2 months old Third dose of hepatitis B vaccine given to baby at 6 months old (but not before 24 weeks old)

Listeriosis (lih-steeree-OH-suhss) An infection with the harmful bacteria called listeria. It is found in some refrigerated and ready-to-eat foods. Infection can cause early delivery or miscarriage. Parvovirus B19 (fifth disease) Most pregnant women who are infected with this virus do not have serious problems. But there is a small chance the virus can infect the fetus. This raises the risk of miscarriage during the first 20 weeks of pregnancy. Fifth disease can cause severe anemia in women who have

Fever, muscle aches, chills Sometimes diarrhea or nausea If progresses, severe headache and stiff neck

Avoid foods that can harbor listeria. Antibiotics are used to treat listeriosis. Learn more from our Pregnancy Food Don'ts Printand-Go Guide (PDF file, 119 Kb).

Low-grade fever Tiredness Rash on face, trunk, and limbs Painful and swollen joints

No specific treatment, except for blood transfusions that might be needed for people who have problems with their immune systems or with red blood cell disorders. There is no vaccine to help prevent infection with this virus.

red blood cell disorders like sicklecell disease or immune system problems. Sexually transmitted infection (STI) An infection that is passed through sexual contact. Many STIs can be passed to the baby in the womb or during birth. Some effects include stillbirth, low birth weight, and lifethreatening infections. STIs also can cause a woman's water to break too early or preterm labor. Toxoplasmosis (TOK-soh-plaz-MOHsuhss) This infection is caused by a parasite, which is found in cat feces, soil, and raw or undercooked meat. If passed to an unborn baby, the infection can cause hearing loss, blindness, or intellectual disabilities.

Symptoms depend on the STI. Often, a woman has no symptoms, which is why screening for STIs during pregnancy is so important. For more information, see our Sexually Transmitted Infections Overview FAQ.

STIs can be prevented by practicing safe sex. A woman can keep from passing an STI to her baby by being screened early in pregnancy. Treatments vary depending on the STI. Many STIs are treated easily with antibiotics.

Mild flu-like symptoms, or possibly no symptoms.

You can lower your risk by:

Washing hands with soap after touching soil or raw meat Washing produce before eating Cooking meat completely Washing cooking utensils with hot, soapy water Not cleaning cats' litter boxes

Medicines are used to treat a pregnant woman and her unborn baby. Sometimes, the baby is treated with medicine after birth.

Urinary tract infection (UTI)

Pain or burning when urinating Frequent

UTIs are treated with antibiotics.

Bacterial infection in urinary tract. If untreated, it can spread to the kidneys, which can cause preterm labor. Yeast infection An infection caused by an overgrowth of bacteria normally found in the vagina. Yeast infections are more common during pregnancy than in other times of a woman's life. They do not threaten the health of your baby. But they can be uncomfortable and difficult to treat in pregnancy.

urination Pelvis, back, stomach, or side pain Shaking, chills, fever, sweats Extreme itchiness in and around the vagina Burning, redness, and swelling of the vagina and the vulva Pain when passing urine or during sex A thick, white vaginal discharge that looks like cottage cheese and does not have a bad smell

Vaginal creams and suppositories are used to treat yeast infection during pregnancy.

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When to Call the Doctor

When you are pregnant don't wait to call your doctor or midwife if something is bothering or worrying you. Sometimes physical changes can be signs of a problem. Call your doctor or midwife as soon as you can if you:

are bleeding or leaking fluid from the vagina have sudden or severe swelling in the face, hands, or fingers get severe or long-lasting headaches have discomfort, pain, or cramping in the lower abdomen have a fever or chills are vomiting or have persistent nausea feel discomfort, pain, or burning with urination have problems seeing or blurred vision feel dizzy suspect your baby is moving less than normal after 28 weeks of pregnancy (if you count less than 10 movements within 2 hours) have thoughts of harming yourself or your baby

Staying Healthy and Safe

Home > Healthy Pregnancy > You're Pregnant: Now What? > Staying Healthy and Safe

Eating for Two Keeping Fit Oral Health Using Medicine and Herbs Having Sex Travel Environmental Risks Quitting Smoking Substance Abuse Abusive Relationships When to Call the Doctor Additional Resources

Eat this. Don't eat that. Do this. Don't do that. Pregnant women are bombarded with dos and don'ts. Here's help to keep it all straight.

Eating for Two

Eating healthy foods is more important now than ever! You need more protein, iron, calcium, and folic acid than you did before pregnancy. You also need more calories. But "eating for two" doesn't mean eating twice as much. Rather, it means that the foods you eat are the main source of nutrients for your baby. Sensible, balanced meals combined with regular physical fitness is still the best recipe for good health during your pregnancy.

Related information

Pregnancy Know-How Quiz Pregnancy Dos and Don'ts Print-and-Go Guide (PDF file, 96 Kb) Fish Facts Print-and-Go Guide (PDF file, 204 Kb) Pregnancy Food Don'ts Printand-Go Guide (PDF file, 119 Kb) Find Your Prepregnancy BMI

Weight Gain

The amount of weight you should gain during pregnancy depends on your body mass index (BMI) before you became pregnant. The Institute of Medicine provides these guidelines:

If you were at a normal weight before pregnancy, you should gain about 25 to 30 pounds. If you were underweight before pregnancy, you should gain between 28 and 40 pounds. If you were overweight before pregnancy, you should gain between 15 and 25 pounds. If you were obese before pregnancy, you should gain between 11 and 20 pounds.

Check with your doctor to find out how much weight gain during pregnancy is healthy for you. You should gain weight gradually during your pregnancy, with most of the weight gained in the last trimester. Generally, doctors suggest women gain weight at the following rate:

2 to 4 pounds total during the first trimester 3 to 4 pounds per month for the second and third trimesters

Where does the added weight go?

Recent research shows that women who gain more than the recommended amount during pregnancy and who fail to lose this weight within six months after giving birth are at much higher risk of being obese nearly 10 years later. Findings from another large study suggest that gaining more weight than the recommended amount during pregnancy may raise your child's odds of being overweight in the future. If you find that you are gaining weight too quickly, try to cut back on foods with added sugars and solid fats. If you are not gaining enough weight, you can eat a little more from each food group.

Baby 6 to 8 pounds Placenta 1 pounds Amniotic fluid 2 pounds Uterus growth 2 pounds Breast growth 2 pounds Your blood and body fluids 8 pounds Your body's protein and fat 7 pounds

Calorie Needs

Your calorie needs will depend on your weight gain goals. Most women need 300 calories a day more during at least the last 6 months of pregnancy than they do prepregnancy. Keep in mind that not all calories are equal. Your baby needs healthy foods that are packed with nutrients not "empty calories" such as those found in soft drinks, candies, and desserts. Although you want to be careful not to eat more than you need for a healthy pregnancy, make sure not to restrict your diet during pregnancy either. If you don't get the calories you need, your baby might not get the right amounts of protein, vitamins, and minerals. Low-calorie diets can break down a pregnant woman's stored fat. This can cause your body to make substances called ketones. Ketones can be found in the mother's blood and urine and are a sign of starvation. Constant production of ketones can result in a child with mental deficiencies.
Foods Good for Mom and Baby

A pregnant woman needs more of many important vitamins, minerals, and nutrients than she did before pregnancy. Making healthy food choices every day will help you give your baby what he or she needs to develop. The MyPyramid for Pregnant and Breastfeeding Women can show you what to eat as well as how much you need to eat from each food group based on your pre-pregnancy BMI and activity level. Use your personal MyPyramid plan to guide your daily food choices. Here are some foods to choose often:

Grains fortified, cooked or ready-to-eat cereals; wheat germ Vegetables carrots, sweet potatoes, pumpkin, spinach, cooked greens, winter squash, tomatoes, red pepper Fruits cantaloupe, honeydew melon, mangoes, prunes or prune juice, bananas, apricots, oranges or orange juice, grapefruit, avocado Dairy nonfat or low-fat yogurt; nonfat milk (skim milk); low-fat milk (1% milk) Meat and beans cooked dried beans and peas; nuts and seeds; lean beef, lamb, and pork; shrimp, clams, oysters, and crab; cod, salmon, polluck, and catfish

Talk to your doctor if you have special diet needs for these reasons:

Diabetes Make sure you review your meal plan and insulin needs with your doctor. High blood glucose levels can be harmful to your baby. Lactose intolerance Find out about low-lactose or reduced-lactose products and calcium supplements to ensure you are getting the calcium you need. Vegetarian Ensure that you are eating enough protein, iron, vitamin B12, and vitamin D. PKU Keep good control of phenylalanine levels in your diet.

Food Safety

Most foods are safe for pregnant women and their babies. But you will need to use caution or avoid eating certain foods. Follow these guidelines:
Clean, handle, cook, and chill food properly to prevent food-borne illness, including listeria and toxoplasmosis. Wash hands with soap after touching soil or raw meat. Keep raw meats, poultry, and seafood from touching other foods or surfaces. Cook meat completely. Wash produce before eating. Wash cooking utensils with hot, soapy water. Do not eat: Refrigerated smoked seafood like whitefish, salmon, and mackerel Hot dogs or deli meats unless steaming hot Refrigerated meat spreads Unpasteurized milk or juices Store-made salads, such as chicken, egg, or tuna salad Unpasteurized soft cheeses, such as unpasteurized feta, Brie, queso blanco, queso fresco, and blue cheeses

Shark, swordfish, king mackerel, or tile fish (also called golden or white snapper); these fish have high levels of mercury. More than 6 ounces per week of white (albacore) tuna Herbs and plants used as medicines without your doctor's okay. The safety of herbal and plant therapies isn't always known. Some herbs and plants might be harmful during pregnancy, such as bitter melon (karela), noni juice, and unripe papaya. Raw sprouts of any kind (including alfalfa, clover, radish, and mung bean)

Fish Facts

Fish and shellfish are a great source of protein and heart-healthy omega-3 fatty acids. But pregnant women shout not eat certain kinds of fish because they contain high levels of a type of mercury that is harmful to developing babies.

Do NOT eat any shark, swordfish, king mackerel, or tilefish (also called golden or white snapper) because these fish have high levels of mercury. Do not eat more than six ounces of "white" or "albacore" tuna or tuna steak each week.

You can safely eat up to 12 ounces per week (about 2 meals) of a variety of cooked fish. Check out our Fish Facts Print-and-Go Guide (PDF file, 204 Kb) for handy tips on eating fish while pregnant. And visit the Center for Food Safety and Applied Nutrition for more information on how much mercury is in different kinds of fish.
Vitamins and Minerals

In addition to making healthy food choices, ask your doctor about taking a prenatal vitamin and mineral supplement every day to be sure you are getting enough of the nutrients your baby needs. You also can check the label on the foods you buy to see how much of a certain nutrient the product contains. Women who are pregnant need more of these nutrients than women who are not pregnant:
Nutrients and Pregnancy

Nutrient

How Much Pregnant Women Need Each Day

Folic acid

400 to 800 micrograms (mcg) (.04 to .08 mg) in the early stages of pregnancy, which is why all women who are capable of pregnancy should take a daily multivitamin that contains 400 to 800 mcg of folic acid. Pregnant women should continue taking folic acid throughout pregnancy.

Iron

27 milligrams (mg)

Calcium 1,000 milligrams (mg); 1,300 mg if 18 or younger Vitamin A Vitamin B12 770 micrograms (mcg); 750 mcg if 18 or younger

2.6 micrograms (mcg)

Women who are pregnant also need to be sure to get enough vitamin D. The current recommendation for all adults under 50 (including pregnant women) is 5 micrograms (mcg) of vitamin D each day. But many health experts don't think this is enough. Ask your doctor how much vitamin D you need each day. Because vitamin D is important to your unborn baby's development, your doctor might want to measure your vitamin D levels to be sure you are getting enough. Keep in mind that taking too much of a supplement can be harmful. For example, too much of the nutrient vitamin A can cause birth defects. For this reason, only take vitamins and mineral supplements that your doctor recommends.
Don't Forget Fluids

All of your body's systems need water. When you are pregnant, your body needs even more water to stay hydrated and support the life inside you. Water also helps prevent constipation, hemorrhoids, excessive swelling, and urinary tract or bladder infections. Not getting enough water can lead to premature or early labor. Your body gets the water it needs through the fluids you drink and the foods you eat. How much fluid you need to drink each day depends on many factors, such as your activity level, the weather, and your size. Your body needs more fluids when it is hot and when you are physically active. It also needs more water if you have a fever or if you are vomiting or have diarrhea. The Institute of Medicine recommends that pregnant women drink about 10 cups of fluids daily. Water, juices, coffee, tea, and soft drinks all count toward your fluid needs. But keep in mind that some beverages are high in sugar and "empty" calories. A good way to tell if your fluid intake is okay is if your urine is pale yellow or colorless and you rarely feel thirsty. Thirst is a sign that your body is on its way to dehydration. Don't wait until you feel thirsty to drink.

Alcohol

There is no known safe amount of alcohol a woman can drink while pregnant. When you are pregnant and you drink beer, wine, hard liquor, or other alcoholic beverages, alcohol gets into your blood. The alcohol in your blood gets into your baby's body through the umbilical cord. Alcohol can slow down the baby's growth, affect the baby's brain, and cause birth defects. Find out more about the dangers of drinking alcohol during pregnancy in our section on Substance Abuse.
Caffeine

Small amounts of caffeine (about one 12-ounce cup of coffee a day) appear to be safe during pregnancy. Some studies have shown a link between higher amounts of caffeine and miscarriage and preterm birth. But there is no solid proof that caffeine causes these problems. The effects of too much caffeine are unclear. Ask your doctor whether drinking a limited amount of caffeine is okay for you.
Cravings

Many women have strong desires for specific foods during pregnancy. The desire for "pickles and ice cream" and other cravings might be caused by changes in nutritional needs during pregnancy. The fetus needs nourishment. And a woman's body absorbs and processes nutrients differently while pregnant. These changes help ensure normal development of the baby and fill the demands of breastfeeding once the baby is born. Some women crave nonfood items such as clay, ice, laundry starch, or cornstarch. A desire to eat nonfood items is called pica (PYE-KUH). Eating nonfood items can be harmful to your pregnancy. Talk to your doctor if you have these urges.
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Keeping Fit
Fitness goes hand in hand with eating right to maintain your physical health and wellbeing during pregnancy. Pregnant or not, physical fitness helps keep the heart, bones, and mind healthy. Healthy pregnant women should get at least 2 hours and 30 minutes of moderate-intensity aerobic activity a week. It's best to spread your workouts throughout the week. If you regularly engage in vigorous-intensity aerobic activity or high amounts of activity, you can keep up your activity level as long as your health doesn't change and you talk to your doctor about your activity level throughout your pregnancy. Special benefits of physical activity during pregnancy:

Exercise can ease and prevent aches and pains of pregnancy including constipation, varicose veins, backaches, and exhaustion.

Active women seem to be better prepared for labor and delivery and recover more quickly. Exercise may lower the risk of preeclampsia and gestational diabetes during pregnancy. Fit women have an easier time getting back to a healthy weight after delivery. Regular exercise may improve sleep during pregnancy. Staying active can protect your emotional health. Pregnant women who exercise seem to have better self-esteem and a lower risk of depression and anxiety. Results from a recent, large study suggest that women who are physically active during pregnancy may lower their chances of preterm delivery.

Getting Started

For most healthy moms-to-be who do not have any pregnancy-related problems, exercise is a safe and valuable habit. Even so, talk to your doctor or midwife before exercising during pregnancy. She or he will be able to suggest a fitness plan that is safe for you. Getting a doctor's advice before starting a fitness routine is important for both inactive women and women who exercised before pregnancy. If you have one of these conditions, your doctor will advise you not to exercise:

Risk factors for preterm labor Vaginal bleeding Premature rupture of membranes (when your water breaks early, before labor)

Best Activity for Moms-to-be

Low-impact activities at a moderate level of effort are comfortable and enjoyable for many pregnant women. Walking, swimming, dancing, cycling, and low-impact aerobics are some examples. These sports also are easy to take up, even if you are new to physical fitness. Some higher intensity sports are safe for some pregnant women who were already doing them before becoming pregnant. If you jog, play racquet sports, or lift weights, you may continue with your doctor's okay. Keep these points in mind when choosing a fitness plan:

Avoid activities in which you can get hit in the abdomen like kickboxing, soccer, basketball, or ice hockey. Steer clear of activities in which you can fall like horseback riding, downhill skiing, and gymnastics. Do not scuba dive during pregnancy. Scuba diving can create gas bubbles in your baby's blood that can cause many health problems.

Tips for Safe and Healthy Physical Activity

Follow these tips for safe and healthy fitness:

When you exercise, start slowly, progress gradually, and cool down slowly. You should be able to talk while exercising. If not, you may be overdoing it. Take frequent breaks. Don't exercise on your back after the first trimester. This can put too much pressure on an important vein and limit blood flow to the baby. Avoid jerky, bouncing, and high-impact movements. Connective tissues stretch much more easily during pregnancy. So these types of movements put you at risk of joint injury. Be careful not to lose your balance. As your baby grows, your center of gravity shifts making you more prone to falls. For this reason, activities like jogging, using a bicycle, or playing racquet sports might be riskier as you near the third trimester. Don't exercise at high altitudes (more than 6,000 feet). It can prevent your baby from getting enough oxygen. Make sure you drink lots of fluids before, during, and after exercising. Do not workout in extreme heat or humidity. If you feel uncomfortable, short of breath, or tired, take a break and take it easier when you exercise again.

Stop exercising and call your doctor as soon as possible if you have any of the following:

Dizziness Headache Chest pain Calf pain or swelling Abdominal pain Blurred vision Fluid leaking from the vagina Vaginal bleeding Less fetal movement Contractions

Work Out Your Pelvic Floor (Kegel Exercises)

Your pelvic floor muscles support the rectum, vagina, and urethra in the pelvis. Toning these muscles with Kegel exercises will help you push during delivery and recover from birth. It also will help control bladder leakage and lower your chance of getting hemorrhoids. Pelvic muscles are the same ones used to stop the flow of urine. Still, it can be hard to find the right muscles to squeeze. You can be sure you are exercising the right muscles if when you squeeze them you stop urinating. Or you can put a finger into the vagina and squeeze. If you feel pressure around the finger, you've found the pelvic floor muscles. Try not to tighten your stomach, legs, or other muscles.

Kegel Exercises 1. Tighten the pelvic floor muscles for a count of 3, then relax for a count of 3. 2. Repeat 10 to 15 times, 3 times a day. 3. Start Kegel exercises lying down. This is the easiest position. When your muscles get stronger, you can do Kegel exercises sitting or standing as you like.
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Oral Health
Before you become pregnant, it is best to have dental checkups every 6 months to keep your teeth and gums healthy. If you are pregnant and have not had regular checkups, consider the following:

Have a complete oral exam early in your pregnancy. Because you are pregnant, you might not receive routine x-rays. But if you must have x-rays for a dental problem needing treatment, the health risk to your unborn baby is small. Dental treatment during pregnancy is safe. The best time for treatment is between the 14th and 20th weeks. During the last months of pregnancy, you might be uncomfortable sitting in a dental chair. Do not avoid necessary dental treatments you may risk your and your baby's health. Use good oral hygiene to control your risk of gum diseases. Pregnant women may have changes in taste and develop red, swollen gums that bleed easily. This condition is called pregnancy gingivitis (jin-juh-VYT-uhss). It can be caused by both poor oral hygiene and higher hormone levels during pregnancy. Until recently, it was thought that having gum disease could raise your risk of having a low-birth-weight baby. Researchers have not been able to confirm this link, but some research is still under way to learn more.

After you give birth, maintain good oral hygiene to protect your baby's oral health. Bacteria that cause cavities can transfer from you to your child by:

A kiss on the mouth Letting your baby put her fingers in your mouth Tasting food on your baby's spoon Testing the temperature of a baby bottle with your mouth
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Using Medicine and Herbs

You and your baby are connected. So medicines you use, including over-the counter, herbal, and prescription drugs Related information or supplements, might get into your baby's system too. Pregnancy and Many medicines and herbs are known to cause problems Medicines FAQ during pregnancy, including birth defects. For some medicines, we don't know that much about how they might affect pregnancy or the developing fetus. This is because medicines are rarely tested on pregnant women for fear of harming the fetus. Mothers-to-be might wonder if it's safe to use medicines during pregnancy. There is no clear-cut answer to this question. Your doctor can help you make the choice whether to use a medicine. Labels on prescription and over-the-counter drugs have information to help you and your doctor make this choice. In the future, a new prescription drug label will make it easier for women and their doctors to weigh the benefits and risks of using prescription medicines during pregnancy.
Always speak with your doctor before you start or stop any medicine. Not using medicine that you need may be more harmful to you and your baby than using the medicine.

Weighing Benefits and Risks

When deciding whether or not to use a medicine in pregnancy, you and your doctor need to talk about the medicine's benefits and the risks.

Benefits what are the good things the medicine can do for me and my growing baby? Risks what are the ways the medicine might harm me or my growing baby?

There may be times during pregnancy when using medicine is a choice. For example, if you get a cold, you may decide to "live with" your stuffy nose instead of using the "stuffy nose" medicine you use when you are not pregnant. Other times during pregnancy, using medicine is not a choice it is needed. For example, you might need to use medicine to control an existing health problem like asthma, diabetes, depression, or seizures. Or, you might need a medicine for a few days, such as an antibiotic to treat a bladder infection or strep throat. Also, some women have a pregnancy problem that needs medicine treatment. These problems include severe nausea and vomiting, earlier pregnancy losses, or preterm labor.
Using Herbal or Dietary Supplements and Other "Natural" Products

You might think herbs are safe because they are "natural." But, except for some vitamins, little is known about using herbal or dietary supplements while pregnant. Some herbal remedy labels claim they will help with pregnancy. But, most often there are no good studies to show if these claims are true or if the herb can cause harm to you or your baby. Also, some herbs that are safe when used in small amounts as food might be harmful when used in large amounts as medicines. So, talk with your doctor

before using any herbal or dietary supplement or natural product. These products may contain things that could harm you or your growing baby.
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Having Sex
Unless your doctor tells you otherwise, sex is safe. You may find that your interest in sex changes during pregnancy. Talk to your partner about other positions if the way you usually have sex is awkward or no longer feels good. Call your doctor if sex causes:

Pain Vaginal bleeding Fluid leakage Buckle up! Wearing a seatbelt during car and air travel is safe while pregnant. The lap strap should go under your belly, across your hips. The shoulder strap should go between your breasts and to the side of your belly. Make sure it fits snugly.

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Travel
Everyday life doesn't stop once you are pregnant. Most healthy pregnant women are able to continue with their usual routine and activity level. That means going to work, running errands, and for some, traveling away from home. To take care of yourself and help keep your baby safe, consider these points before taking a long trip or traveling far from home:

Talk to your doctor before making any travel decisions that will take you far from home. Ask if any health conditions you might have makes travel during pregnancy unsafe. Also consider the destination. Is the food and water safe? Will you need immunizations before you go? Is there good medical care available in the event of an emergency? Will your health insurance cover medical care at your destination? Also, avoid traveling to very high altitudes (12,000 feet). Bring a copy of your medical record and find out about medical care at your destination so you will be prepared in the event of an emergency.

Avoid sitting for long periods during car or air travel. Prolonged sitting can affect blood flow in your legs. Take frequent, 10 minute breaks while traveling by car to walk and stretch. Stand up, and move your legs often during air travel. Wearing support pantyhose also can help blood flow. If you suspect a problem with your pregnancy during your trip, don't wait until you come home to see your doctor. Seek medical care right away.
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Environmental Risks
The environment is everything around us wherever we are at home, at work, or outdoors. While you don't need to worry about every little thing you breathe in or eat, it's smart to avoid exposure to substances that might put your pregnancy or unborn baby's health at risk. During pregnancy, avoid exposure to:

Lead found in some water and paints, mainly in homes built before 1978 Mercury the harmful form is found mainly in large fish. See our Fish Facts Print-andGo Guide. Arsenic high levels can be found in some well water Pesticides both household products and agricultural pesticides Solvents such as degreasers and paint strippers and thinners Cigarette smoke

Keep in mind: We don't know how much exposure can lead to problems, such as miscarriage or birth defects. That is why it's best to avoid or limit your exposure as much as possible. Here are some simple, day-to-day precautions you can take:

Clean in only well-ventilated spaces. Open the windows or turn on a fan. Check product labels for warnings for pregnant women and follow instructions for safe use. Do not clean the inside of an oven while pregnant. Leave the house if paint is being used, and don't return until the fumes are gone.

If you are exposed to chemicals in the workplace, talk to your doctor and your employer about what you can do lower your exposure. Certain industries, such as dry cleaning, manufacturing, printing, and agriculture, involve use of toxins that could be harmful. If you are concerned about the safety of your drinking water, call your health department or water supplier to ask about the quality of your tap water or how to have your water tested. Or, call the Environmental Protection Agency's Safe Drinking Water Hotline at (800) 426-4791. Don't assume that bottled water is better or safer. Usually, bottle water offers no health benefits over tap water.
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Quitting Smoking
Smoking cigarettes is very harmful to your health and could also affect the health of your baby. Not only does smoking cause cancer and heart disease in people who smoke, a recent large study confirmed that smoking during pregnancy increases the risk of low birth weight. Related information Low-birth-weight babies are at higher risk of health Smoking and How to problems shortly after birth. Also, some studies have Quit linked low birth weight with a higher risk of health problems later in life, such as high blood pressure and diabetes. Women who smoke during pregnancy are more likely than other women to have a miscarriage and to have a baby born with cleft lip or palate, types of birth defects. Also, mothers who smoke during or after pregnancy put their babies at greater risk of sudden infant death syndrome (SIDS). Mothers who smoke have many reasons to quit smoking. Take care of your health and your unborn baby's health by asking your doctor for help quitting smoking. Quitting smoking is hard, but you can do it with help!
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Substance Abuse
Using alcohol and illegal drugs during pregnancy threatens the health of your unborn baby. So does using legal drugs in an inappropriate way. When you use alcohol or drugs, the chemicals you ingest or breathe into your lungs cross the placenta and enter your baby. This puts your baby at risk for such problems as stillbirth, low birth weight, birth defects, behavioral problems, and developmental delays.
Alcohol

When you drink alcohol, so does your baby. Pregnant women should not drink alcohol to eliminate the chance of giving birth to a baby with fetal alcohol spectrum disorder (FASD). FASD involves a range of harmful effects that can occur when a fetus is exposed to alcohol. The effects can be mild to severe. Children born with a severe form of FASD can have abnormal facial features, severe learning disabilities, behavioral problems, and other problems. You might think a drink now and then won't hurt your baby. But we don't know how much alcohol it takes to cause harm. We do know that the risk of FASD, and the likely severity, goes up with the amount of alcohol consumed during pregnancy. Also, damage from alcohol can occur in the earliest stages of pregnancy often before a woman knows she is pregnant. For this reason, women who may become pregnant also should not drink.

Illegal Drugs

Many women who use illegal drugs also use tobacco and alcohol. So, it's not always easy to tell the effects of one drug from that of alcohol, tobacco, or other drugs. We do know that using illegal drugs during pregnancy is very dangerous. Babies born to women who use drugs such as cocaine, heroine, and methamphetamine are likely to be born addicted and must go through withdrawal. Mothers who inject drugs are at higher risk of getting HIV, which can be passed to an unborn baby. Some studies suggest that the effects of drug use during pregnancy might not be seen until later in childhood.
Getting Help for Alcohol or Drug Use

If you drink alcohol or use drugs and cannot quit, talk to your doctor right away. Treatment programs can help pregnant women with addiction and abuse. To find help near you, go to the Substance Abuse Treatment Facility Locator. You can quit using and give your baby a good start to life.
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Abusive Relationships
It's hard to be excited about the new life growing inside of you if you're afraid of your partner. Abuse from a partner Related information can begin or increase during pregnancy and can harm you Violence Against and your unborn baby. Women who are abused often Women don't get the prenatal care their babies need. Abuse from a partner also can lead to preterm birth and low-birthweight babies, stillbirth and newborn death, and homicide. If you are abused, you might turn to alcohol, cigarettes, or drugs to help you cope. This can be even more harmful to you and your baby. You may think that a new baby will change your situation for the better. But the cycle of abuse is complex, and a baby introduces new stress to people and relationships. Now is a good time to think about your safety and the safety and wellbeing of your baby. About 50 percent of men who abuse their wives also abuse their children. Think about the home environment you want for your baby. Studies show that children who witness or experience violence at home may have long-term physical, emotional, and social problems. They are also more likely to experience or commit violence themselves in the future. Prenatal exams offer a good chance to reach out for help. It's possible to take control and leave an abusive partner. But for your and your baby's safety, talk to your doctor first. Let motherhood prompt you to take action now.
If you're a victim of abuse or violence at the hands of someone you know or love, or you are recovering from an assault by a stranger, you and your baby can get immediate help

and support. The National Domestic Violence Hotline can be reached 24 hours a day, 7 days a week at 800-799-SAFE (7233) and 800-787-3224 (TTY). Spanish speakers are available. When you call, you will first hear a recording and may have to hold. Hotline staff offer crisis intervention and referrals. If requested, they connect women to shelters and can send out written information. The National Sexual Assault Hotline can be reached 24 hours a day, 7 days a week at 800656-4673. When you call, you will hear a menu and can choose #1 to talk to a counselor. You will then be connected to a counselor in your area who can help you. You can also visit the National Sexual Assault Online Hotline.
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When to Call the Doctor

When you are pregnant, do not hesitate to call your doctor or midwife if something is bothering or worrying you. Sometimes physical changes can be signs of a problem. Call your doctor or midwife as soon as you can if you:

are bleeding or leaking fluid from the vagina have sudden or severe swelling in the face, hands, or fingers get severe or long-lasting headaches have discomfort, pain, or cramping in the lower abdomen have a fever or chills are vomiting or have persistent nausea feel discomfort, pain, or burning with urination have problems seeing or blurred vision feel dizzy suspect your baby is moving less than normal after 28 weeks of pregnancy (if you count less than 10 movements within 2 hours) have thoughts of harming yourself or your baby

Body Changes and Discomforts

Home > Healthy Pregnancy > You're Pregnant: Now What? > Body Changes and Discomforts

Body Aches Breast Changes Constipation Dizziness Fatigue, Sleep Problems Heartburn and Indigestion Hemorrhoids

Itching Leg Cramps Morning Sickness Nasal Problems Numb or Tingling Hands Stretch Marks, Skin Changes Swelling Urinary Frequency and Leaking Varicose Veins Additional Resources

Everyone expects pregnancy to bring an expanding waistline. But many women are surprised by the other body changes that pop up. Get the low-down on stretch marks, weight gain, heartburn and other "joys" of pregnancy. Find out what you can do to feel better.
Body Changes and Discomforts During Pregnancy

During pregnancy, you might have:

What might help:

Call the doctor if:

Body Aches
As your uterus expands, you may feel aches and pains in the back, abdomen, groin area, and thighs. Many women also have backaches and aching near the pelvic bone due the pressure of the baby's head, increased weight, and loosening joints. Some pregnant women complain of pain that runs from the lower back, down the back of one leg, to the knee or foot. This is called sciatica (SYE-AT-ick-uh). It is thought to occur when the uterus puts pressure on the sciatic nerve.

Lie down. Rest. Apply heat.

Pain does not get better.

Breast Changes
A woman's breasts increase in size and fullness during pregnancy. As the due date approaches, hormone changes will cause your breasts to get even bigger to prepare for breastfeeding. Your breasts may feel full, heavy, or tender.

Wear a maternity bra with good support. Put pads in bra to absorb leakage.

In the third trimester, some pregnant women begin to leak colostrum (cohLOSS-truhm) from their breasts. Colostrum is the first milk that your breasts produce for the baby. It is a thick, yellowish fluid containing antibodies that protect newborns from infection.

Constipation
Many pregnant women complain of constipation. Signs of constipation include having hard, dry stools; fewer than three bowel movements per week; and painful bowel movements. Higher levels of hormones due to pregnancy slow down digestion and relax muscles in the bowels leaving many women constipated. Plus, the pressure of the expanding uterus on the bowels can contribute to constipation.

Drink 8 to 10 glasses of water daily. Don't drink caffeine. Eat fiber-rich foods, such as fresh or dried fruit, raw vegetables, and whole-grain cereals and breads. Try mild physical activity Stand up slowly. Avoid standing for too long. Don't skip meals. Lie on your left side. Wear loose clothing.

Dizziness
Many pregnant women complain of dizziness and lightheadedness throughout their pregnancies. Fainting is rare but does happen even in some healthy pregnant women. There are many reasons for these symptoms. The growth of more blood vessels in early pregnancy, the pressure of the expanding uterus on blood vessels, and the body's increased need for food all can make a pregnant woman feel lightheaded and dizzy.

You feel faint and have vaginal bleeding or abdominal pain.

Fatigue, Sleep Problems

During your pregnancy, you might feel tired even after you've had a lot of sleep. Many women find they're

Lie on your left side. Use pillows for support, such as behind your back,

exhausted in the first trimester. Don't worry, this is normal! This is your body's way of telling you that you need more rest. In the second trimester, tiredness is usually replaced with a feeling of well being and energy. But in the third trimester, exhaustion often sets in again. As you get larger, sleeping may become more difficult. The baby's movements, bathroom runs, and an increase in the body's metabolism might interrupt or disturb your sleep. Leg cramping can also interfere with a good night's sleep.

tucked between your knees, and under your tummy. Practice good sleep habits, such as going to bed and getting up at the same time each day and using your bed only for sleep and sex. Go to bed a little earlier. Nap if you are not able to get enough sleep at night. Drink needed fluids earlier in the day, so you can drink less in the hours before bed. Eat 6 to 8 small meals instead of 3 large meals eat slowly. Drink fluids between meals not with meals. Don't eat greasy and fried foods. Avoid citrus fruits or juices and spicy foods. Do not eat or drink within a few hours of bedtime. Do not lie down right after meals.

Heartburn and Indigestion

Hormones and the pressure of the growing uterus cause indigestion and heartburn. Pregnancy hormones slow down the muscles of the digestive tract. So food tends to move more slowly and digestion is sluggish. This causes many pregnant women to feel bloated. Hormones also relax the valve that separates the esophagus from the stomach. This allows food and acids to come back up from the stomach to the esophagus. The food and acid causes the burning feeling of heartburn. As your baby gets bigger, the uterus pushes on the stomach making heartburn more common in later pregnancy.

Symptoms don't improve after trying these suggestions. Ask your doctor about using an antacid.

Hemorrhoids
Hemorrhoids (HEM-roidz) are swollen and bulging veins in the rectum. They can cause itching, pain, and bleeding. Up to 50 percent of pregnant women get hemorrhoids. Hemorrhoids are common during pregnancy for many reasons. During pregnancy blood volume increases greatly, which can cause veins to enlarge. The expanding uterus also puts pressure on the veins in the rectum. Plus, constipation can worsen hemorrhoids. Hemorrhoids usually improve after delivery.

Drink lots of fluids. Eat fiber-rich foods, like whole grains, raw or cooked leafy green vegetables, and fruits. Try not to strain with bowel movements. Talk to your doctor about using products such as witch hazel to soothe hemorrhoids. Use gentle soaps and moisturizing creams. Avoid hot showers and baths. Avoid itchy fabrics.

Itching
About 20 percent of pregnant women feel itchy during pregnancy. Usually women feel itchy in the abdomen. But red, itchy palms and soles of the feet are also common complaints. Pregnancy hormones and stretching skin are probably to blame for most of your discomfort. Usually the itchy feeling goes away after delivery.

Symptoms don't improve after a week of self-care.

Leg Cramps
At different times during your pregnancy, you might have sudden muscle spasms in your legs or feet. They usually occur at night. This is due to a change in the way your body processes calcium.

Gently stretch muscles. Get mild exercise. For sudden cramps, flex your foot forward. Eat calcium-rich foods. Ask your doctor about calcium supplements.

Morning Sickness
In the first trimester hormone changes can cause nausea and vomiting. This is called "morning sickness," although it can occur at any time of day. Morning sickness usually tapers off by the second trimester.

Eat 6 to 8 small meals instead of 3 large meals to keep your stomach from being empty. Don't lie down after meals. Eat dry toast, saltines, or dry cereals before getting out of bed in the morning. Eat bland foods that are low in fat and easy to digest, such as cereal, rice, and bananas. Sip on water, weak tea, or clear soft drinks. Or eat ice chips. Avoid smells that upset your stomach. Blow your nose gently. Drink fluids and use a cool mist humidifier. To stop a nosebleed, squeeze your nose between your thumb and forefinger for a few minutes. Take frequent breaks to rest hands. Ask your doctor

You have flulike symptoms, which may signal a more serious condition. You have severe, constant nausea and/or vomiting several times every day.

Nasal Problems
Nosebleeds and nasal stuffiness are common during pregnancy. They are caused by the increased amount of blood in your body and hormones acting on the tissues of your nose.

Nosebleeds are frequent and do not stop after a few minutes.

Numb or Tingling Hands

Feelings of swelling, tingling, and numbness in fingers and hands, called carpal tunnel syndrome, can occur

during pregnancy. These symptoms are due to swelling of tissues in the narrow passages in your wrists, and they should disappear after delivery.

about fitting you for a splint to keep wrists straight.

Stretch Marks, Skin Changes

Stretch marks are red, pink, or brown streaks on the skin. Most often they appear on the thighs, buttocks, abdomen, and breasts. These scars are caused by the stretching of the skin, and usually appear in the second half of pregnancy. Some women notice other skin changes during pregnancy. For many women, the nipples become darker and browner during pregnancy. Many pregnant women also develop a dark line (called the linea nigra) on the skin that runs from the belly button down to the pubic hairline. Patches of darker skin usually over the cheeks, forehead, nose, or upper lip also are common. Patches often match on both sides of face. These spots are called melasma or chloasma and are more common in darker-skinned women.

Be patient stretch marks and other changes usually fade after delivery.

Swelling
Many women develop mild swelling in the face, hands, or ankles at some point in their pregnancies. As the due date approaches, swelling often becomes more noticeable.

Drink 8 to 10 glasses of fluids daily. Don't drink caffeine or eat salty foods. Rest and elevate your feet. Ask your doctor about support hose. Take frequent bathroom breaks.

Your hands or feet swell suddenly or you rapidly gain weight it may be preeclampsia.

Urinary Frequency and

You experience

Leaking
Temporary bladder control problems are common in pregnancy. Your unborn baby pushes down on the bladder, urethra, and pelvic floor muscles. This pressure can lead to more frequent need to urinate, as well as leaking of urine when sneezing, coughing, or laughing.

Drink plenty of fluids to avoid dehydration. Do Kegel exercises to tone pelvic muscles.

burning along with frequency of urination it may be an infection.

Varicose Veins
During pregnancy blood volume increases greatly. This can cause veins to enlarge. Plus, pressure on the large veins behind the uterus causes the blood to slow in its return to the heart. For these reasons, varicose veins in the legs and anus (hemorrhoids) are more common in pregnancy. Varicose veins look like swollen veins raised above the surface of the skin. They can be twisted or bulging and are dark purple or blue in color. They are found most often on the backs of the calves or on the inside of the leg.

Avoid tight kneehighs. Sit with your legs and feet raised.

Additional Resources
Know Your Pregnancy Rights
Home > Healthy Pregnancy > You're Pregnant: Now What? > Know Your Pregnancy Rights

Additional Resources

When sharing your good news with coworkers, discrimination might be the last thing on your mind. But the truth is that many women are treated unfairly or even fired after revealing the news of their pregnancy. As long as a pregnant woman is able to perform the major functions of her job, not hiring or firing her because she is pregnant is against the law. It's against the law to dock her pay or demote her to a lesser position because of pregnancy. It's also against the law to hold back benefits for pregnancy because a woman is not married. All are forms of pregnancy discrimination, and all are illegal.

Women are protected under the Pregnancy Discrimination Act. It says that businesses with at least 15 employees must treat women who are pregnant in the same manner as other job applicants or employees with similar abilities or limitations. The Family and Medical Leave Act also protects the jobs of workers who are employed by companies with 50 employees or more and who have worked for the company for at least 12 months. These companies must allow employees to take 12 weeks of unpaid leave for medical reasons, including pregnancy and childbirth. Your job cannot be given away during this 12-week period. Many state laws also protect pregnant women's rights. These laws appear clear cut. But issues that arise on the job seldom are. Go to the U.S. Equal Employment Opportunity Commission web site to learn more about your rights during pregnancy and what to do if you think your rights have been violated.