Ectopic Pregnancy

WHAT IS AN ECTOPIC PREGNANCY?

"Ectopic" is Latin for "in the wrong place." An ectopic pregnancy, also referred to as tubal pregnancy, occurs when a developing embryo plants itself outside the uterus. Most ectopic pregnancies are found in the fallopian tube, but they can occur at other pelvic sites such as the ovary, cervix, or abdominal cavity. The embryo cannot survive outside the uterus and must be removed to prevent maternal complications. This type of pregnancy is potentially dangerous and requires immediate treatment.

WHAT CAUSES AN ECTOPIC PREGNANCY?

An ectopic pregnancy occurs when a fertilized egg is slowed or blocked in some way as it travels from the ovary to the uterus. There are associated risk factors that put some women at a higher risk for an ectopic pregnancy:

• previous pelvic functions
• fibroids in the uterus, which block the tube's entrance to the uterus
• use of an intrauterine device (IUD) for contraception
• previous tubal pregnancy or uterine surgery
• in-vitro fertilization
• history of endometriosis
• adhesions (band of scar tissue) fromprevious abdominal surgery
• repeated occurrence of sexually transmitted infections
• smoking

WHAT ARE THE SIGNS AND SYMPTOMS OF AN ECTOPIC PREGNANCY?

An ectopic pregnancy may be characterized by:

• missed menstrual period or abnormally light or abnormally heavy period
• any unexplained vaginal spotting
• low abdominal cramping, especially on one side of the abdomen
• weakness, dizziness associated with any of the above symptoms

Early detection of an ectopic pregnancy is imperative. If a tubal pregnancy is allowed to continue, it may rupture the fallopian tube and cause massive bleeding. This can result in a decrease in fertility and even death.
With appropriate treatment, most women are able to have a normal pregnancy after an ectopic
pregnancy; but they should be monitored carefully when trying to conceive in the future.


Source : The Board of Trustees of the University of Illinois, 2002.

Oh, baby! What's it going to cost?

The biggest investment of your life won't come cheap. As you anticipate the joys of parenthood, a few mundane matters beg to be considered. One of the most fundamental is the question of money.

The bottom line is, inquiring minds want to know: What's it going to cost me?

Good question. Unfortunately, there's no easy answer. The glib answer is this: a lot. A whole lot. Probably more than you really care to ponder. But of course, the intangible rewards will always outweigh the financial investment associated with having a baby and raising it to healthy young adulthood. That said, there are some rough guidelines regarding what you can expect to spend over the next 18 years or so.

From diapers to formula to car seats, from cribs and baby-room curtains to insurance and medical care, your expenses are about to increase dramatically. And if you think you've got it harder than your parents, chances are you're absolutely right. According to one government estimate, published in the late 1990s, the cost of raising a child from birth to 18 had risen by 20 percent since 1960. And most estimates do not take into account lost wages due to one parent taking time off to raise the children. How is your hard-earned cash about to evaporate? Let me count the ways.

Some figures to ponder

For purposes of this discussion, estimates are based on the costs of raising a child in a dual-parent, two-child family. Costs for single parent families and only-child families will vary somewhat. Estimates are based on data collected by the U. S. Department of Agriculture from 1990 through 1992 through the Consumer Expenditure Survey. Figures have been adjusted to 1998 dollars.

Lower income

Households with a before-tax income of up to $ 36,000 can expect to spend about $ 115,000 per child to raise a child from cradle to 18. This does not take into account the considerable expenses of prenatal care and delivery, nor does it consider the skyrocketing costs of a college education. What the estimate does include is expenditures for housing, food, transportation, clothing, health care, childcare/education and a little extra for miscellaneous expenses (Pokémon cards?).

Middle income

Couples in the $ 36,000 to $ 60,600 annual income category can expect to spend even more. Raising just one of the two children used for the purposes of this illustration will cost this couple $ 156,690 in 1998 dollars. And remember, this estimate does not include the costs of prenatal care or delivery. Nor does it make allowances for children of less-than-average health.

Higher income

Higher income couples, earning in excess of $ 60,600 per year can expect to spend about $ 228,690 per child. The USDA expects that parents of an only child will spend slightly more on that child, and suggests multiplying the appropriate figure above by 1.24 to arrive at a more realistic estimate. Conversely, parents of three or more children are generally expected to spend slightly less per child, and USDA recommends multiplying the appropriate single child cost by 0.77. Costs drop slightly with each additional child, due to the "buy-in-bulk" factor, among other reasons.

What about "before and after" costs?

Naturally, everyone's expenses will be different. Infertility treatments and problem pregnancies can cause initial expenses to skyrocket, before your baby ever arrives. Likewise the costs of adoption. On the other end of the equation, college expenses vary wildly, depending on whether your child will qualify for scholarships or financial aid, and whether he or she plans to attend a state college or a private institution. Generally speaking, the cheapest higher education is available at state institutions. Expect to pay far more for private and out-of-state institutions.

In the 1990s, the average cost of a college education in this nation rose approximately 7.5% per year, while overall inflation was a more palatable 2.6%. Clearly, managing the cost of higher education is an enormous challenge for the average American family. At the same time, attaining an undergraduate degree has never been more important to attaining a middle-class lifestyle.

Parents hoping to put their children through college have no choice but to begin investing in some form of college savings or investment plan as early as possible. Waiting until kindergarten, for example, can nearly double the amount you will need to sock away each month, just to catch up, thanks to the magic of compounded growth.

Early financial planning can help

There are several steps you can take now, which will improve your overall financial picture. First, look into the insurance coverage offered by your employer. Find out what types of prenatal and pregnancy/delivery benefits are available to you. Second, determine if your wife will qualify for disability coverage while on maternity leave. Next, find out what it will cost to add dependents to your medical insurance plan. If both parents work, one parent's coverage may be more cost-effective than the other's. Consider starting a savings account dedicated to baby-related expenses, such as buying furniture or redecorating the baby's room.

If you are a two-career couple, take a hard look at the costs of paying for quality childcare versus the income generated by the spouse in the lower-income job. In some cases, when transportation costs are factored in, it makes more sense financially for one parent to stay at home to raise the child, rather than paying someone else to do so. Given the high cost of childcare, one income with no childcare expenses may actually be more cost-effective than two, with childcare expenses.

Another important tool for cutting your expenses is the use of pre-tax dollar childcare plans, offered by some larger employers. If this plan is available to you, be sure to sign up. It can significantly reduce your childcare expenses, which will be paid with pre-tax dollars. If such a plan is unavailable to you, be sure to take the childcare tax credit on your income tax return.

Consider forming a baby-sitting cooperative in your area to save on the costs of an occasional night out. By swapping sitting duties, everyone gets a scheduled break, and no one pays.

Finally, as children age, train them to be smart shoppers and responsible money handlers. By teaching them the value of money -- how to earn it, how to spend wisely and how to save -- everyone wins in the long run.

Source : thebabycorner.com

Prepare to Breast Feed Your Baby

Breastfeeding your baby can be a rewarding experience for you both. Not only are you providing essential nutrients, but the act of breastfeeding is a bonding experience like no other. If you’ve decided that you will breastfeed your new baby, there are some things you can do while you’re still pregnant to prepare.

Educate Yourself

During your third trimester, learn as much as you can about breastfeeding. Talk to friends or family members about their experiences and get advice and tips. Read up on breastfeeding by visiting your local library and browsing the stacks of breastfeeding books (The Womanly Art of Breastfeeding by La Leche League International and The Baby Book by William Sears, MD, and Martha Sears, RN, IBCLC, are two excellent resources). Also, sign up to take a breastfeeding class – most hospitals offer birthing classes that teach breastfeeding techniques – or contact a local lactation consultant for a one-on-one tutorial.

You can also attend a La Leche League meeting if there is one in your area. It will give you the opportunity to meet mothers who are currently breastfeeding, and will be an excellent source of information and support after your baby is born. Visit LLI.org for details on meetings, as well as information on breastfeeding including articles, a mother-to-mother forum, and podcasts.

Create a Relaxing Environment

Breastfeeding should be a soothing and relaxing time you share with your baby. Create a spot in the house where you can put your feet up and rest in a comfortable chair while your baby eats. A comfortable environment will mean that both you and baby are relaxed and not stressed, making breastfeeding easier for you both.

You may also want to buy a nursing pillow to raise baby up to the correct position and make breastfeeding easier on your back. Baby stores carry the Boppy and/or Brest Friend nursing pillows. Try each one on, and see which one feels more comfortable and fits you best. Be sure to purchase an extra cover for your nursing pillow, so when one gets wet or dirty it can easily be replaced with a fresh one.

Build a Support Network

Talk to your spouse or partner, pediatrician, nurse practitioner or ob/gyn and others in your network about your choice to breastfeed. Make sure you have a supportive of and enthusiastic network of people who can answer your questions and provide support.

Prepare Yourself Physically

Experts now agree that “toughening your nipples” by rubbing them is not necessary and may actually cause uterine contractions that can stress the baby. However, you should avoid using soaps or lotions on your breasts and nipples, and other irritating or drying agents, during the last weeks of pregnancy and while you are nursing.

If you have flat or inverted nipples, you can still breastfeed successfully. However, there are some things you might want to do to make things easier for you and your baby, such as breast shields or massage. If you think that you have inverted nipples, talk to your nurse or ob/gyn or contact a lactation resource such as LaLeche League for advice and tips for breastfeeding success.

Stock up on Supplies

There are a few essentials that breastfeeding mothers should have. First, you will need a few nursing bras. These will provide the extra support you will need, and have handy flaps that can easily be undone at feeding times. During your last few weeks of pregnancy, visit a department store and get fitted for a nursing bra.

Second, stock up on breast pads to prevent embarrassing leaks. Another baby’s cries or the sight of an infant can stimulate milk flow when you least expect it. Nursing pads can help prevent leaks and stains on your clothing.

Third, if you will be going back to work but wish to continue breastfeeding, or if you will be traveling without your baby, a breast pump is essential. By pumping breast milk, you will keep your supply up and also keep your baby on a milk-rich diet. You can also use a pump to increase your milk supply. Find out more about choosing a pump and pumping breast milk.

Breastfeeding is a rewarding and joyful experience, and can be accomplished with a little advanced planning and preparation.


Source : thebabycorner.com

Causes of Bleeding During Pregnancy

There can be many causes for vaginal bleeding during pregnancy, which can range from mild to serious. However, as alarming as it might be to find that you are spotting or bleeding while you are pregnant, be advised that most women who bleed during pregnancy – primarily during the first trimester – go on to deliver healthy babies at term.

It’s important to know the most common causes of vaginal bleeding during each stage of pregnancy so that you can know what to watch for and when to contact your health care provider.

First Trimester Bleeding or Spotting

Light vaginal bleeding experienced during the first 12 weeks of pregnancy can occur due to a host of causes. The American Pregnancy Association reports that studies show that 20-30% of women experience some degree of bleeding in early pregnancy. Following are some of the causes for bleeding in the first trimester.

Implantation. When the fertilized egg implants into the lining of your uterus, it can cause some spotting. This usually occurs at about 10 to 14 days after fertilization, and is spottier and lighter in color than a normal menstrual period. Women sometimes do mistake this light bleeding for a period and don’t realize that they’re pregnant.

Miscarriage. Vaginal bleeding is the primary sign of miscarriage; however, bleeding doesn't necessarily mean that you're having a miscarriage. The American Pregnancy Association reports that about half of pregnant women who bleed do not have miscarriages. Approximately 15-20% of all pregnancies result in a miscarriage, most of which occur during the first 12 weeks. Up to 15% of known pregnancies end in miscarriage, according to the American College of Obstetricians and Gynecologists.

Ectopic pregnancies. Ectopic pregnancy is when the fertilized egg implant somewhere outside the uterus, most commonly in the fallopian tube. Ectopic pregnancies are less common than miscarriages, occurring in 1 of 60 pregnancies, the American Pregnancy Association reports.

Molar pregnancies. Molar pregnancy is the rare case of an abnormal mass (instead of a baby) forming inside the uterus after fertilization. It is also referred to as gestational trophoblastic disease (GTD). Signs include bleeding, unusually high hCG levels, and absent fetal heart tones.

The Mayo Clinic suggests that if you have slight vaginal bleeding that goes away within a day, tell your health care provider at your next visit. If you experience bleeding that lasts more than a day, contact your health care provider within the next 24 hours. Contact him or her immediately if you experience moderate to heavy vaginal bleeding; experience any amount of bleeding accompanied by abdominal pain, cramping, fever or chills; or pass tissue from your vagina.

Second or Third Trimester Bleeding or Spotting

During the third trimester, the cervix begins to thin out in preparation for preparation for labor. When this happens, the mucus plug that had been sealing the opening of the cervix is dislodged and you may notice a thick or stringy discharge, sometimes tinged with blood.

This "bloody show" is a normal sign of impending labor, and may occur up to a week or two before delivery. However, there are some other causes of bleeding that can be ore serious, including the following.

Miscarriage. Again, vaginal bleeding is the primary sign of miscarriage. Although most common during the first trimester, there is still a risk for miscarriage in the second trimester.

Preterm labor. Light bleeding in the second or third trimester may be a sign of preterm labor, especially if you are also experiencing regular contractions, a dull backache, or pelvic pressure.

Placenta previa or placental abruption. Painless, bright red vaginal bleeding in the second or third trimester may be a sign of placenta previa, a serious problem where the placenta partly or completely covers the opening to the birth canal. Placental abruption is when the placenta begins to separate from the inner wall of the uterus before the baby is born. Bleeding may be slight to heavy, or in between, and is usually accompanied by abdominal pain.

Uterine rupture. Uterine rupture is a rare condition in which the uterus tears open along the scar line from a prior C-section. Vaginal bleeding, intense abdominal pain and abdominal tenderness may result. If this happens, either before or during labor, an emergency C-section is needed to prevent life-threatening complications.

Your health care provider should be contacted if you have any amount of vaginal bleeding in the second or third trimester. Most likely, you will need to be examined in the doctor's office or hospital. Call your doctor immediately if you have vaginal bleeding paired with pain, cramping, fever or chills, or contractions.

Bleeding during pregnancy can be worrisome. By understanding the most common causes of vaginal bleeding during pregnancy, you'll be prepared and know when it’s wise to contact your health care provider.

Source : thebabycorner.com

Your pregnancy: 41 weeks

How your baby's growing:

A bit over 20 inches long, your baby has continued to grow and may now weigh almost 8 pounds. As cozy as he is, your baby can't stay inside you forever. For your baby's safety, your practitioner will talk with you about inducing labor if your baby isn't born in the next week — earlier if there are any problems. Most practitioners won't let you wait more than two weeks past your due date to give birth because it puts you and your baby at increased risk for complications. About 5 to 6 percent of women have prolonged pregnancies that extend three or more weeks beyond their estimated due dates. Babies born at 42 weeks and beyond can have dry parchment-like skin and are often overweight. Waiting that long to deliver also increases your chance of developing an infection in your uterus that could be dangerous for your baby or of having a stillbirth. What's more, your labor is more likely to be prolonged or stalled, both you and your baby have an increased risk of injury during a vaginal delivery, and you double your chances of needing a c-section.

See what your baby looks like this week.

Note: Experts say every baby develops differently — even in utero. This developmental information is designed to give you a general idea of how your baby is growing in your womb.

How your life is changing:

It's hard not to be anxious when your due date comes and goes and you're still hugely pregnant (especially when well-meaning family and friends keep calling to check on your status!). But don't fret — you won't be pregnant forever. There's a good chance you'll go into labor on your own this week, and if you don't, you'll be induced by 42 weeks, or earlier if you or your baby has any problems.

The methods your practitioner uses to induce labor will depend on the condition of your cervix. If your cervix hasn't started to soften, efface (thin out), or dilate (open), it's considered "unripe," or not yet ready for labor. In that case, your practitioner will use either hormones or "mechanical" methods to ripen your cervix before the induction. Sometimes these will end up jump-starting your labor as well. Depending on your situation, the procedures can include stripping or rupturing your membranes, or using drugs like oxytocin (Pitocin) to start your contractions. If these and other methods don't work, you'll end up having a c-section.

In the meantime, be sure to tell your practitioner immediately if your baby's movements slow down or if any fluid is leaking from your vagina.

A Warm Welcome "If you have other children, let them help you plan a low-key birthday party for the new baby, complete with a birthday cake and decorations. From their perspective, it'll add to the perks of having a new baby in the house." — Kate


Source : babycenter.com

Your pregnancy: 40 weeks

See the big picture

How your baby's growing:

It's hard to say for sure how big your baby will be, but the average newborn weighs about 7 1/2 pounds (a small pumpkin) and is about 20 inches long. His skull bones are not yet fused, which allows them to overlap a bit if it's a snug fit through the birth canal during labor. This so-called "molding" is the reason your baby's noggin may look a little conehead-ish after birth. Rest assured — it's normal and temporary.

See what your baby looks like this week.

Note: Every baby develops a little differently — even in the womb. Our information is designed to give you a general idea of your baby's development.

How your life's changing:

After months of anticipation, your due date rolls around, and... you're still pregnant. It's a frustrating, but common, situation in which to find yourself. You may not be as late as you think, especially if you're relying solely on a due date calculated from the day of your last period because sometimes women ovulate later than expected. Even with reliable dating, some women have prolonged pregnancies for no apparent reason.

You still have a couple of weeks before you'll be considered "post-term." But to be sure your baby is still thriving, your practitioner will schedule you for testing to keep an eye on her if your pregnancy continues.

You may have a biophysical profile (BPP), which consists of an ultrasound to look at your baby's overall movements, breathing movements (movement of her chest muscles and diaphragm), and muscle tone (whether she opens and closes her hand or extends and then flexes her limbs), as well as the amount of amniotic fluid that surrounds her (important because it's a reflection of how well the placenta is supporting your baby).

Fetal heart rate monitoring (called a nonstress test or NST) will generally be done as well — by itself or as part of the BPP. Or, you may have what's known as a modified BPP, which consists of an NST and an ultrasound to assess the amount of amniotic fluid.

If the fetal testing isn't reassuring — the amniotic fluid level is too low, for example — you'll be induced. If there's a serious, urgent problem, you may have an immediate c-section.

Your practitioner will also check your cervix to see if it's "ripening." Its position, how soft it is, how effaced (thinned out) it is, and how dilated (open) it is can all affect when and how your labor is induced. If you don't go into labor on your own, you'll be induced, usually sometime between 41 and 42 weeks.

3 Questions About...Inducing labor

Q1.

What does it mean to induce labor?

If your labor doesn't start on its own, your practitioner can use certain medications and techniques to help bring on or "induce" contractions. She'll do this when the risks of prolonging your pregnancy are higher than the risks of induction. Most practitioners will induce labor if you're still pregnant between one and two weeks after your due date. This is because the placenta may become less effective at delivering nutrients at around 42 weeks, and other serious complications become more likely as you pass your due date.

Q2.

How is labor induced?

There are a variety of methods, and the one your practitioner uses will depend on your individual situation — in part, on the condition of your cervix (whether it's ripe or not) and the urgency of the induction.

Typically, if you need to be induced but your cervix is not yet dilated or thinned out, you'll be admitted to the hospital and your caregiver will likely start off the induction by inserting medication that contains prostaglandins into your vagina. This medication helps to ripen the cervix and may also stimulate enough contractions to start your labor.

If the prostaglandins don't put you into labor, your caregiver will then administer a drug called Pitocin (also known as oxytocin). It's given through an IV and used to start labor or augment contractions you've been having on your own. (If your cervix is ripe to begin with, she'll start with the Pitocin straightaway.)

Q3.

Are there any techniques for kickstarting labor that I can try myself?

There are no do-it-yourself techniques consistently proven to be both safe and effective so don't try anything without guidance from your caregiver. Here's the scoop on some of the methods you may have heard about:

• Sexual intercourse: Semen contains prostaglandins and having an orgasm may stimulate some contractions. A few studies have shown that having sex at term may decrease the need for labor induction, but others have shown it has no effect on promoting labor.

• Nipple stimulation: Stimulating your nipples releases oxytocin, and it may help start labor, but more research is needed to determine the safety and effectiveness of this method. Because it may overstimulate your uterus, your contractions and your baby's response to them would need to be monitored so don't try this at home.

• Castor oil is a strong laxative, and stimulating your bowels may cause some contractions. There's no definitive proof that it helps induce labor though plenty of women can attest to its unpleasant effects!

• Herbal remedies: A variety of herbs are touted as useful for labor induction. Some are risky because they can cause contractions that are too long or too strong and may be unsafe for your baby for other reasons as well. For others, the safety and effectiveness remain unknown.

This Week's Activity:

Kick back and relax. Rent some movies, read a novel, curl up with a stack of magazines or a new CD, sleep in or grab catnaps when you can.You're in the final stretch and you deserve some downtime! If you're go-go-go right up until delivery you'll be depleted by the time your baby arrives, says clinical psychologist Diane Sanford.

Your pregnancy: 39 weeks

How your baby's growing:

Your baby's waiting to greet the world! He continues to build a layer of fat to help control his body temperature after birth, but it's likely he already measures about 20 inches and weighs a bit over 7 pounds, a mini watermelon. (Boys tend to be slightly heavier than girls.) The outer layers of his skin are sloughing off as new skin forms underneath.

See what your baby looks like this week.

Note: Every baby develops a little differently — even in the womb. Our information is designed to give you a general idea of your baby's development.

How your life's changing:

At each of your now-weekly visits, your caregiver will do an abdominal exam to check your baby's growth and position. She might also do an internal exam to see whether your cervix has started ripening: softening, effacing (thinning out), and dilating (opening). But even armed with this information, there's still no way for your caregiver to predict exactly when your baby is coming. If you go past your due date, your caregiver will schedule you for fetal testing (usually a sonogram) after 40 weeks to ensure that it's safe to continue the pregnancy. If you don't go into labor on your own, most practitioners will induce labor when you're between one and two weeks overdue — or sooner if there's an indication that the risk of waiting is greater than the risks of delivering your baby without further delay.

While you're waiting, it's important to continue to pay attention to your baby's movements and let your caregiver know right away if they seem to decrease. Your baby should remain active right up to delivery, and a noticeable slowdown in activity could be a sign of a problem. Also call if you think your water may have broken. Membranes rupture before the beginning of labor in about 8 percent of term pregnancies. Sometimes there's a big gush of fluid, but sometimes there's only a small gush or a slow leak. (Don't try to make the diagnosis yourself. Call even if you only suspect you have a leak.) If you rupture your membranes and don't start contractions on your own, you'll be induced.

Surprising Facts: How your body changes after giving birth

Even if your labor and delivery was fast and easy, it will take some time for you to feel like your old self again. It may be hard, but try to remember that it took nine months to get here, so you won't bounce back — emotionally or physically — overnight.

What to expect from your body:

• You'll start losing weight right away. While you probably won't return to your pre-pregnancy weight for some time, most women are about 12 pounds lighter after delivering one 7- to 9-pound baby and losing another pound or two of placenta and another two pounds or so of blood and amniotic fluid. Although it will take a while for your body to regain its pre-pregnancy shape — that pregnant belly may stick around for longer than you'd like — by the end of the first week, you'll probably have lost about 4 pounds of water weight.

• You'll have lochia discharge. After your baby is born, the cells that form the lining of your uterus will begin to slough off. This results in a discharge called lochia that lasts for weeks. At first, this discharge is mixed with blood, so it appears bright red and menstrual-like, then it gradually gets lighter in color, finally fading to white or yellow before it stops.

• Your emotions will be in flux. Within the first week or two of giving birth, many new moms experience the "baby blues." You may find yourself moody and weepy, exhausted, unable to sleep, or feeling trapped or anxious. Your appetite can change, too — you might want to eat more or less. The good news is this emotional upheaval will generally pass within two to three weeks.

Call your caregiver if: • You have signs of abnormal vaginal bleeding, such as soaking more than one sanitary pad in an hour, passing blood clots bigger than a golf ball, or bright red bleeding that occurs four days or more after you give birth. You may have what's called a delayed postpartum hemorrhage. (Note: Call 911 if you're bleeding profusely or if you have any signs of shock, including lightheadedness, weakness, rapid heartbeat or palpitations, rapid or shallow breathing, clammy skin, restlessness, or confusion.)
• You have signs of infection, which may include any fever; lower abdominal pain or foul-smelling discharge (signs of endometritis); difficulty urinating, painful urination, cloudy or bloody urine (signs of a urinary tract infection); redness, tenderness, discharge, or swelling around the site of a wound (such as a c-section incision, episiotomy, or laceration); a painful, hard, reddened area, usually only on one breast, and fever, chills, muscle aches or fatigue, and possibly a headache (signs of mastitis, a breast infection).

• You have signs of postpartum depression, such as being unable to sleep even when your baby sleeps, having any thoughts of harming your child, crying all day long for several days in a row, or having panic attacks.

How to recover more quickly:

• Get as much rest as you can, and make an effort to sleep when your baby sleeps. This can be tough advice to follow, especially during the day, but it really helps.

• Limit visitors and the time you spend with them. Consider turning off the phone and posting a "we're napping" message on your door to discourage drop-ins.

• Eat a well-balanced diet.

• Drink plenty of fluids. Avoid caffeine, alcohol, and sugared sodas.

• Accept all offers for help with cooking, cleaning, childcare, errands, and the like. If you aren't receiving offers, ask for help. It's hard, but trust us, your friends and family want to help and most will be honored you asked. If you can't get help for free, consider hiring a mother's helper, cleaning lady, or others who can give you a break.

• Don't isolate yourself. Talking to friends, relatives, and other new moms about your birth experience and life with a newborn can help you cope.

This Week's Activity:

If you're planning to breastfeed and haven't bought nursing bras yet, now is the time. Bring them to the hospital — you'll want them for comfort and support. Your breasts are likely much larger now than pre-pregnancy, and they'll probably increase one or two more sizes while you're nursing. While you're shopping, get some breast pads to tuck into your bra to absorb any leaks and some purified or "medical-grade" lanolin ointment for tender nipples. (Avoid lanolin if you're allergic to wool.)


Source : babycenter.com

Your pregnancy: 38 weeks

How your baby's growing:

Your baby has really plumped up. She weighs about 6.8 pounds and she's over 19 1/2 inches long (like a leek). She has a firm grasp, which you'll soon be able to test when you hold her hand for the first time! Her organs have matured and are ready for life outside the womb.

Wondering what color your baby's eyes will be? You may not be able to tell right away. If she's born with brown eyes, they'll likely stay brown. If she's born with steel gray or dark blue eyes, they may stay gray or blue or turn green, hazel, or brown by the time she's 9 months old. That's because a child's irises (the colored part of the eye) may gain more pigment in the months after she's born, but they usually won't get "lighter" or more blue. (Green, hazel, and brown eyes have more pigment than gray or blue eyes.)

See what your baby looks like this week.

Note: Every baby develops a little differently — even in the womb. Our information is designed to give you a general idea of your baby's development.

How your life's changing:

For many women, the next couple of weeks are a waiting game. Use this time to prepare your baby's nursery or to take care of necessary tasks you may not get around to for a while after your baby's born. Take naps, catch up on your reading, and spend uninterrupted time with your partner while you can.

Some swelling in your feet and ankles is normal during these last weeks, but call your practitioner without delay if you notice excessive or sudden swelling of your feet or ankles, more than slight swelling of your hands, any swelling in your face or puffiness around your eyes, or have a sudden weight gain. Also let her know immediately if have severe or persistent headaches; visual changes (such as double or blurred vision, seeing spots or flashing lights, light sensitivity, or a temporary loss of vision), intense upper abdominal pain or tenderness, or nausea and vomiting. These are symptoms of a serious condition called preeclampsia.

3 Questions About... Preparing to breastfeed

Q1.

Why is breastfeeding considered the best way to feed a baby?

Breast milk is nature's most perfect food for babies. It has just the right proportion and types of proteins, carbs, and fats, along with almost all of the vitamins and minerals that a baby needs in the first six months of life. Dozens of studies have confirmed the benefits of breastfeeding and new ones are published all the time. Here's a look at some of the highlights. Breastfeeding can:

• help protect your baby from diarrhea, respiratory problems, and ear infections.
• reduce your baby's risk for allergies, leukemia, and possibly obesity.
• reduce your stress level and risk of breast cancer.

Q2.

What can I do to prepare for breastfeeding?

You can set yourself up for breastfeeding success by reading about how to breastfeed and learning where to turn for help if the going gets rough. Here are four key things to know:

• Insist that you and your baby have skin-to-skin contact immediately after birth (unless either of you has a medical complication) so you can start breastfeeding as soon as possible. If you have a c-section, ask that your baby join you in the recovery room as soon as your surgery is done.

• Realize that nursing doesn't come naturally to every woman, and if you're feeling discouraged, you're not alone. Get help early while you're still at the hospital or birth center to make sure you and your baby get the hang of breastfeeding before you go home.

• Nurse your newborn frequently — eight to 12 times every 24 hours. And unless medically necessary, your baby shouldn't get anything but breast milk until breastfeeding is well established (for the first few weeks at least).

• For more information, see BabyCenter's comprehensive breastfeeding area.

Q3.

Does breastfeeding hurt?

Just because breastfeeding is the most natural way to nourish your baby doesn't mean it's always easy. For many women, breastfeeding can be uncomfortable or even painful at first. Don't suffer in silence. Pain is often an indication that your baby isn't attached to your breast properly. Her mouth should cover a large part of your areola (the pigmented skin around your nipple). Your nipple should be far back in your baby's mouth. If nursing hurts after your baby's first few sucks, break the suction by inserting your little finger between your baby's gums and your nipple — and try again until you find a position that's less painful. Talk to a lactation consultant before you leave the hospital to make sure your baby is latching on to your breast correctly. If your hospital doesn't provide lactation support or you encounter difficulties after leaving the hospital, you can contact La Leche League International for help.

Some women are totally comfortable breastfeeding in public, while others feel self-conscious. If you're worried about it, carry a jacket or extra blanket with you when you go out with your baby. That way, if he needs to nurse before while you're out, you can drape it over your shoulder and your baby's head for privacy.

This Week's Activity:

Start reading up on baby care. If you haven't already, now is the perfect time to switch reading gears from pregnancy to baby. You won't have as much time to read after your baby's born, so learn all you can about the first few weeks now. A good place to start is BabyCenter's Preparing for a Newborn area.


Source : babycenter.com

Your pregnancy: 37 weeks

How your baby's growing:

Congratulations — your baby is full term! This means that if your baby arrives now, his lungs should be fully mature and ready to adjust to life outside the womb, even though your due date is still three weeks away.

Your baby weighs 6 1/3 pounds and measures a bit over 19 inches, head to heel (like a stalk of Swiss chard). Many babies have a full head of hair at birth, with locks from 1/2 inch to 1 1/2 inches long. But don't be surprised if your baby's hair isn't the same color as yours. Dark-haired couples are sometimes thrown for a loop when their children come out as blonds or redheads, and fair-haired couples have been surprised by Elvis look-alikes. And then, of course, some babies sport only peach fuzz.

See what your baby looks like this week.

Note: Every baby develops a little differently — even in the womb. Our information is designed to give you a general idea of your baby's development.

How your life's changing:

Braxton Hicks contractions may be coming more frequently now and may last longer and be more uncomfortable. You might also notice an increase in vaginal discharge. If you see some "bloody show" (mucus tinged with a tiny amount of blood) in the toilet or in your undies, labor is probably a few days away — or less. (If you have heavier spotting or bleeding, call your caregiver immediately.) Also be sure to ask your caregiver about the results of your Group B strep culture. That way, if the result isn't yet on your chart when you get to the hospital or birth center, you'll be able to give the staff there a timely heads-up if you need antibiotics.

It may be harder than ever to get comfortable enough to sleep well at night. If you can, take it easy through the day — this may be your last chance to do so for quite a while. Keep monitoring your baby's movements, too, and let your caregiver know immediately if you notice a decrease. Though her quarters are getting cozy, she should still be as active as before.

While you're sleeping, you're likely to have some intense dreams. Anxiety both about labor and about becoming a parent can fuel a lot of strange flights of unconscious fancy.

Home alone "I know some people are thrilled to show off their new baby. But all I wanted to do was curl up with her in my arms when I got home from the hospital. Next time I'll tell people ahead of time that we aren't seeing visitors for the first week." — Anonymous

Surprising Facts: Signs of labor

There's no way to predict when labor is going to start. Your body actually starts "preparing" for labor up to a month before you give birth. You may be blissfully unaware of what's going on or you may begin to notice new symptoms as your due date draws near.

Here are some things that may happen in the weeks or days before labor starts:

• Your baby drops. If this is your first pregnancy, you may feel what's known as "lightening" a few weeks before labor starts as your baby descends lower into your pelvis. You might detect a heaviness in your pelvis as this happens and notice less pressure just below your ribcage, making it easier to catch your breath.

• You note an uptick in Braxton Hicks contractions. More frequent and intense Braxton Hicks contractions can signal pre-labor, during which your cervix ripens and the stage is set for true labor. Some women experience a crampy, menstrual-like feeling during this time.

• You pass your mucus plug. The mucus plug is the small amount of thickened mucus that blocks the cervical canal leading to your uterus. The plug may come out all at once in a lump, or as increased vaginal discharge over the course of several days. The mucus may be tinged with blood (which may be brown, pink, or red), in which case it may be referred to as "bloody show."

• Your water breaks. Most women start having regular contractions sometime before their water breaks, but in some cases, the water breaks first. When this happens, labor usually follows soon. (If contractions don't start promptly on their own, you'll be induced.) Whether the amniotic fluid comes out in a large gush or a small trickle, call your doctor or midwife.

How can I tell if I'm in false labor or true labor?
Sometimes it's very hard to tell false labor from the early stages of true labor. Here are some things that might help you sort it out:
• False labor contractions are unpredictable. They come at irregular intervals and vary in length and intensity. Although true labor contractions may be irregular at first, over time they start coming at regular and shorter intervals, become increasingly more intense, and last longer.
• With false labor, the pain from the contractions is more likely to be centered in your lower abdomen. With true labor, you may feel the pain start in your lower back and wrap around to your abdomen.
• False labor contractions may subside on their own, or when you start or stop an activity or change position. True labor contractions will persist and progress regardless of what you do.

This Week's Activity:

Figure out how to install your baby's car seat. You can't bring your baby home without a car seat and it's harder to install than you think, so don't wait until the last minute. Some car seat manufacturers have a toll-free number for you to call so an expert can walk you through the process. Or get a car seat safety inspector to help you. To find one in your area, go to the National Highway Traffic Safety Administration's Web site or look in your local phone book.


Source : babycenter.com

Your pregnancy: 36 weeks

How your baby's growing:

Your baby is still packing on the pounds — at the rate of about an ounce a day. She now weighs almost 6 pounds (like a crenshaw melon) and is more than 18 1/2 inches long. She's shedding most of the downy covering of hair that covered her body as well as the vernix caseosa, the waxy substance that covered and protected her skin during her nine-month amniotic bath. Your baby swallows both of these substances, along with other secretions, resulting in a blackish mixture, called meconium, will form the contents of her first bowel movement.

At the end of this week, your baby will be considered full-term. (Full-term is 37 to 42 weeks; babies born before 37 weeks are pre-term and those born after 42 are post-term.) Most likely she's in a head-down position. But if she isn't, your practitioner may suggest scheduling an "external cephalic version," which is a fancy way of saying she'll try to coax your baby into a head-down position by manipulating her from the outside of your belly.

See what your baby looks like this week. (Or see what fraternal twins look like in the womb this week.)

Note: Every baby develops a little differently — even in the womb. Our information is designed to give you a general idea of your baby's development.

How your life's changing:

Now that your baby is taking up so much room, you may have trouble eating a normal-size meal. Smaller, more frequent meals are often easier to handle at this point. On the other hand, you may have less heartburn and have an easier time breathing when your baby starts to "drop" down into your pelvis. This process — called lightening — often happens a few weeks before labor if this is your first baby. (If you've given birth before, it probably won't happen before labor starts.) If your baby drops, you may also feel increased pressure in your lower abdomen, which may make walking increasingly uncomfortable, and you'll probably find that you have to pee even more frequently. If your baby is very low, you may feel lots of vaginal pressure and discomfort as well. Some women say it feels as though they're carrying a bowling ball between their legs!

You might also notice that your Braxton Hicks contractions are more frequent now. Be sure to review the signs of labor with your practitioner and find out when she wants to hear from you. As a general rule, if you're full-term, your pregnancy is uncomplicated, and your water hasn't broken, she'll probably have you wait to come in until you've been having contractions that last for about a minute each, coming every five minutes for an hour. Of course, you'll want to call right away if you notice a decrease in your baby's activity or think you're leaking amniotic fluid, or if you have any vaginal bleeding, fever, a severe or persistent headache, constant abdominal pain, or vision changes.

Even if you're enjoying an uncomplicated pregnancy, it's best to avoid flying (or any travel far from home) during your final month because you can go into labor at any time. In fact, some airlines won't let women on board who are due to deliver within 30 days of the flight.

Eating in "Start collecting take-out and delivery menus from local restaurants. You won't have time to cook in the early weeks after giving birth. Even restaurants without a visible take-out business will usually accommodate a to-go order (especially if it's for a new mom!)." — Kristina

Surprising Facts: The stages of labor

For first-time moms, labor takes an average of 15 hours, though it's not uncommon to last more than 20. (For women who've previously had a vaginal birth, it takes eight hours, on average.) The process of labor and birth is divided into three main stages. Here are the highlights on how childbirth progresses:

First stage The first stage begins when you start having contractions that progressively dilate and efface your cervix and it ends when your cervix is fully dilated. This stage is divided into two phases, early and active labor.

It can be tricky to determine exactly when early labor starts. That's because early labor contractions are sometimes hard to distinguish from the inefficient Braxton Hicks contractions that you may have been feeling for some time.

Unless there are complications or your midwife or doctor has advised you otherwise, expect to sit out most of your early labor at home. (Be sure, though, to check in with your caregiver to make certain.)

Early labor ends when your cervix is about 4 centimeters dilated and your progress starts to speed up. At this point, you enter what's known as the active phase of labor. Your contractions become more frequent, longer, and stronger.

The last part of the active phase — when your cervix dilates from 8 to 10 centimeters — is called the transition period because it marks the transition to the second stage of labor. This is the most intense part of the first stage, with contractions that are usually very strong, coming about every two and a half to three minutes and lasting a minute or more.

Second stage Once your cervix is fully dilated, the second stage of labor begins: the final descent and birth of your baby. This is the "pushing" stage of labor, and it can last anywhere from minutes to a few hours. (It's likely to be quicker if you've previously given birth vaginally.)

Your baby's head will continue to advance with each push until it "crowns" — the term used to describe the time when the widest part of your baby's head is finally visible. After your baby's head comes out, your midwife or doctor will suction his mouth and nose, and feel around his neck for the umbilical cord. His head then turns to the side as his shoulders rotate inside the pelvis to get into position for their exit. With the next contraction, you'll be coached to push as his shoulders deliver, one at a time, followed by the rest of his body.

You may feel a wide range of emotions now: euphoria, awe, pride, disbelief, excitement (to name a few), and, of course, intense relief that it's all over. Exhausted as you may be, you'll also probably feel a burst of energy, and any thoughts of sleep will vanish for the time being.

Stage three The final stage of labor begins immediately after the birth of your baby and ends with the delivery of your placenta. The contractions in the third stage are relatively mild.

Get a more detailed account of what happens during each stage of labor.

This Week's Activity:

Create a grapevine. Make a list of all the people you want to hear about your baby's birth — with their phone numbers or e-mail addresses — and pass this along to a friend who can spread the news. That way, when you're ready for others to know, all you have to do is make one call. Include at least one person from work on the list, so they can spread the word there.


Source : babycenter.com

Your pregnancy: 35 weeks

How your baby's growing:

Your baby doesn't have much room to maneuver now that he's over 18 inches long and tips the scales at 5 1/4 pounds (pick up a honeydew melon). Because it's so snug in your womb, he isn't likely to be doing somersaults anymore, but the number of times he kicks should remain about the same. His kidneys are fully developed now, and his liver can process some waste products. Most of his basic physical development is now complete — he'll spend the next few weeks putting on weight.

See what your baby looks like this week.

Note: Every baby develops a little differently — even in the womb. Our information is designed to give you a general idea of your baby's development.

How your life's changing:

Your uterus — which was entirely tucked away inside your pelvis when you conceived — now reaches up under your rib cage. If you could peek inside your womb, you'd see that there's more baby than amniotic fluid in there now. Your ballooning uterus is crowding your other internal organs, too, which is why you probably have to urinate more often and may be dealing with heartburn and other gastrointestinal distress. If you're not grappling with these annoyances, you're one of the lucky few.

From here on out, you'll start seeing your practitioner every week. Sometime between now and 37 weeks, she'll do a vaginal and rectal culture to check for bacteria called Group B streptococci (GBS). (Don't worry — the swab is the size of a regular cotton swab, and it won't hurt at all.) GBS is usually harmless in adults, but if you have it and pass it on to your baby during birth, it can cause serious complications, such as pneumonia, meningitis, or a blood infection. Because 10 to 30 percent of pregnant women have the bacteria and don't know it, it's vital to be screened. (The bacteria come and go on their own — that's why you weren't screened earlier in pregnancy.) If you're a GBS carrier, you'll get IV antibiotics during labor, which will greatly reduce your baby's risk of infection.

This is also a good time to create a birth plan. Using our form will help you focus on specifics — like who'll be present, what pain management techniques you want to try, and where you want your baby to stay after you deliver. It will give you a starting point to discuss your preferences with your medical team. Childbirth is unpredictable, and chances are you won't follow your plan to the letter, but thinking about your choices ahead of time — and sharing your preferences with your caregiver — should take some of the anxiety out of the process.

Prep early for those first weeks "To streamline a chore like filling out birth announcements, address and stamp your envelopes now while you're still in control of your time." — Laura

3 Questions About...Arriving at the hospital

Q1.

How can I prepare for my arrival at the hospital?

Long before you go into labor, you and your partner should map out the most direct route to the hospital or birth center. Find out where to park, keeping in mind that you'll be leaving your car for at least 24 hours. Ask the hospital staff where you should enter if you arrive after-hours. Most hospitals offer tours of the obstetrical floor at designated times. Taking advantage of these tours will give you a chance to do a dry run before the big day.

Q2.

What should I do when I get to the hospital?

If you've preregistered, you should follow the instructions you've been given, which probably include breezing right by the front desk and going directly to the maternity ward. If you haven't preregistered, you can probably still head directly to the maternity ward. There's usually a check-in desk once you get there. The staff there will help you deal with any necessary paperwork.

A nurse may lead you directly to a birthing room and pair you with a labor and delivery nurse. If it's not clear that you're in active labor or need to be admitted for other reasons, she'll most likely bring you to an exam room first. Your caregiver will evaluate you there to see if you're ready to be admitted.

The nurse will ask you for a urine sample and have you change your clothes. Then she'll check your vital signs and ask when your contractions started and how far apart they are, whether your water's broken, and whether you've had any vaginal bleeding. She'll also want to know if your baby's been moving, if you've recently had anything to eat or drink, and how you're coping with the pain.

Your caregiver will check the frequency and duration of your contractions as well as your baby's heart rate. Then she'll perform an abdominal and vaginal exam. If it looks like you're not in labor or are still in early labor— and everything is okay with you and your baby — you'll probably be sent home until your labor is further along. Otherwise, you'll be admitted.

Q3.

What will happen once I'm admitted?

The nurse or your caregiver may ask if you have a birth plan. Even if you don't have a written plan, share your needs and preferences with the staff, including your feelings about using pain medication during labor.

Then you'll have blood drawn (to find out your blood type among other things) and an IV may be started. You'll definitely need an IV to get antibiotics if you test positive for Group B strep, for hydration if you can't keep fluids down, if you want a spinal or an epidural, if you need oxytocin (Pitocin), or if you have any health problems or pregnancy complications.

Your nurse or caregiver should also orient you, showing you where everything is in your room and where your partner can get ice for you. Don't be shy about requesting things you might need, like a rocking chair, a cool washcloth, or another blanket, or asking any lingering questions you might have. And if you're going to have continuous electronic fetal monitoring and are interested in how it works, ask her to explain which lines on the strip show your contractions and which show the heartbeat, and let her know if you'd prefer the volume on the machine to be turned up or down.

Talk to your caregiver about preregistering at the hospital. If you prepare the paperwork now, you won't have to worry about it on the big day.

• Did you let nature take its course or did you try to plan your baby's birth for a particular day, month, or season?

This Week's Activity:

Prepare food to eat after your baby's born. If you cook, start doubling recipes and freezing half. You and your partner will be too exhausted to cook in the first weeks after you bring your baby home and you'll be thrilled to have healthy meals you can heat up fast. If you don't cook, go around your neighborhood and pick up all the takeout and delivery menus you can find. You'll be grateful for all the options at your fingertips.


Source : babycenter.com

Your pregnancy: 33 weeks

How your baby's growing:

This week your baby weighs a little over 4 pounds (heft a pineapple) and has passed the 17-inch mark. He's rapidly losing that wrinkled, alien look and his skeleton is hardening. The bones in his skull aren't fused together, which allows them to move and slightly overlap, thus making it easier for him to fit through the birth canal. (The pressure on the head during birth is so intense that many babies are born with a conehead-like appearance.) These bones don't entirely fuse until early adulthood, so they can grow as his brain and other tissue expands during infancy and childhood.

See what your baby looks like this week.

Note: Every baby develops a little differently — even in the womb. Our information is designed to give you a general idea of your baby's development.

How your life's changing:

As your baby fills out even more of your belly, lots of things might start to change: Whereas before you were sashaying, you may find yourself waddling. Finding an easy position to sit in — let alone sleep — is becoming more of a challenge. And bumping into chairs and counters is par for the course.

You may be feeling some achiness and even numbness in your fingers, wrists, and hands. Like many other tissues in your body, those in your wrist can retain fluid, which can increase pressure in the carpal tunnel, a bony canal in your wrist. Nerves that run through this "tunnel" may end up pinched, creating numbness; tingling, shooting or burning pain; or a dull ache. Try wearing a splint to stabilize your wrist or propping your arm up with a pillow when you sleep. If your work requires repetitive hand movements (at a keyboard or on an assembly line, for instance), remember to stretch your hands when you take breaks — which should be frequently.

Many women are still feeling sexy at this stage — and their partners often agree. You may need to make some adjustments, but for most women, sex during pregnancy is fine right up until their water breaks or their labor starts.

Bored with pregnancy? Try this! "Every time I start to get bored with my pregnancy, I lie down and rub my belly. Sure enough, my baby starts to kick, and I think about how wonderful it will be when I'm able to hold him." — Barbara

3 Questions About... Monitoring your baby's movements

Q1.

How often should I feel movements?

Your baby should be moving as frequently as she has for the last month or so. Every baby has her own pattern of activity and there's no correct one. As long as you don't notice any major changes in your baby's activity level, chances are she's doing just fine.

Q2.

Do I need to keep track of my baby's kicks?

For an added sense of security, many practitioners recommend that after 28 weeks, you formally monitor your baby's movements at least once or twice a day. There are lots of different ways to do these "kick counts," so check with your caregiver about how she wants you to track your baby's movements. Here's one common approach: Choose a time of day when your baby tends to be active. (Ideally, you'll want to do the counts at roughly the same time each day.) Sit quietly or lie on your side so you won't get distracted. Time how long it takes for you to feel ten distinct movements — kicks, twitches, and whole body movements all count. You should feel at least ten movements within two hours. (Don't worry; it probably won't take that long. Sometimes you'll feel ten kicks within the first ten minutes.) If you don't feel ten movements in two hours, stop counting and call your midwife or doctor.

Q3.

What should I do if I think my baby's movements have slowed down or changed?

Let your practitioner know right away if you notice a slowdown of your baby's movements. A decrease in fetal movement may signal a problem, and you'll need a nonstress test or biophysical profile to check on your baby.

This Week's Activity:

Wash your baby's clothing and bedding. You know all those adorable outfits you bought or received at your baby shower? You should wash anything that will go near your baby's skin to remove any irritants in the fabrics. The gentlest detergents are those designed for babies and those that are labeled hypoallergenic or good for sensitive skin.


Source : babycenter.com

Your pregnancy: 31 weeks

How your baby's growing:

This week, your baby measures over 16 inches long. He weighs about 3.3 pounds (try carrying four navel oranges) and is heading into a growth spurt. He can turn his head from side to side, and his arms, legs, and body are beginning to plump out as needed fat accumulates underneath his skin. He's probably moving a lot, too, so you may have trouble sleeping because your baby's kicks and somersaults keep you up. Take comfort: All this moving is a sign that your baby is active and healthy.

See what your baby looks like this week.

Note: Every baby develops a little differently — even in the womb. Our information is designed to give you a general idea of your baby's development.

How your life's changing:

Have you noticed the muscles in your uterus tightening now and then? Many women feel these random contractions — called Braxton Hicks contractions — in the second half of pregnancy. Often lasting about 30 seconds, they're irregular, and at this point, they should be infrequent and painless. Frequent contractions, on the other hand — even those that don't hurt — may be a sign of preterm labor. Call your practitioner immediately if you have more than four contractions in an hour or any other signs of preterm labor: an increase in vaginal discharge or a change in the type of discharge (if it becomes watery, mucus-like, or bloody — even if it's pink or just tinged with blood); abdominal pain or menstrual-like cramping; an increase in pressure in the pelvic area; or low back pain, especially if you didn't have it before.

You may have noticed some leaking of colostrum, or "premilk," from your breasts lately. If so, try tucking some nursing pads into your bra to protect your clothes. (And if not, it's certainly nothing to worry about; your breasts are making colostrum all the same, even if you don't see any.) If your current bra is too snug, you might also want to pick up a nursing bra. Choose a nursing bra at least one cup size bigger than you need now. When your milk comes in you'll be grateful for that extra room!

If you're having a boy, you and your partner will want to take some time to think about whether or not to have your baby circumcised. Find out the pros and cons from your doctor, and what the procedure involves.

Choosing a focal point "I'm 31 weeks along, and at my childbirth classes they've been telling us to concentrate on a focal point during labor. Anything from a picture to a crack in the wall or ceiling can work, so long as it helps Mom relax and distracts her from the pain." — Anonymous

Decision Guide: Do you want pain medication during labor?

There's no one right way to have a baby. Every woman's experience with pain is different and every labor is different. Some women know in advance that they want pain medication. Some are committed to a natural, unmedicated approach to pain management. And some want to try for a drug-free birth with the option of pain medication if the going gets too rough. Learn all you can about the pros and cons of the various options so that you can make an informed choice. Here are some things to consider as you make your decision:

• If you haven't done so already, sign up for a childbirth education class with your partner. Instructors generally cover all labor pain relief options, including epidurals, spinals, and systemic medication as well as drug-free approaches like breathing and relaxation techniques.

• Most women opt for some kind of pain medication during childbirth. The most popular form of labor pain relief, an epidural, delivers continuous pain relief to the lower part of your body while allowing you to remain fully conscious.

• Some women choose a natural, drug-free approach to controlling labor pain. If you want to remain in control of your body to the greatest extent possible, be an active participant throughout labor, and have minimal routine interventions in the birth process, then natural approaches will suit you best. If you choose to go this route, you accept the potential for pain and discomfort as part of giving birth, but with the right preparation and support, you may find it works well for you.

• Whether you've decided to use pain medication during labor or are committed to natural childbirth, remember that you have the right to change your mind once you're in labor.

• Take our poll: Have you decided to use drugs during childbirth?

This Week's Activity:

You don't need to pack your bag yet, but start making a list of items to bring to the hospital. Besides a change of clothes and a toothbrush, some items to include:
• A photograph or object to focus on during labor
• Snacks to keep your energy up and gum or mints for bad breath
• Cozy socks and slippers
• Your favorite pillow
• Some light reading material
• A nursing nightie and nursing bra
• A going-home outfit for your baby
• A camera or camcorder, fresh batteries, and film, if necessary


Source : babycenter.com

Your pregnancy: 29 weeks

How your baby's growing:

Your baby now weighs about 2 1/2 pounds (like a butternut squash) and is a tad over 15 inches long from head to heel. His muscles and lungs are continuing to mature, and his head is growing bigger to make room for his developing brain. To meet his increasing nutritional demands, you'll need plenty of protein, vitamins C, folic acid, and iron. And because his bones are soaking up lots of calcium, be sure to drink your milk (or find another good source of calcium, such as cheese, yogurt, or enriched orange juice). This trimester, about 250 milligrams of calcium are deposited in your baby's hardening skeleton each day.

See what your baby looks like this week.

Note: Every baby develops a little differently — even in the womb. Our information is designed to give you a general idea of your baby's development.

How your life's changing:

Your baby's very active now. Your practitioner may ask you to spend some time each day counting kicks and will give you specific instructions on how to do this. Let her know if you ever notice a decrease in activity. You may need a nonstress test or biophysical profile to check on your baby's condition.

Some old friends — heartburn and constipation — may take center stage now. The pregnancy hormone progesterone relaxes smooth muscle tissue throughout your body, including your gastrointestinal tract. This relaxation, coupled with the crowding in your abdomen, slows digestion, which in turn can cause gas and heartburn — especially after a big meal — and contribute to constipation as well.

Your growing uterus may also be contributing to hemorrhoids. These swollen blood vessels in your rectal area are common during pregnancy and usually clear up in the weeks after giving birth. If they're itchy or painful, try soaking in a sitz bath or applying cold compresses medicated with witch hazel to the affected area. Also avoid sitting or standing for long stretches. Talk with your practitioner before using any over-the counter remedies during pregnancy, and let her know if you have any rectal bleeding. To prevent constipation, eat a high-fiber diet, drink plenty of water, and get some regular exercise.

Some women get something called "supine hypotensive syndrome" during pregnancy, where laying flat on your back causes a change in heart rate and blood pressure that makes you feel dizzy until you change position. You might note that you feel lightheaded if you stand up too quickly, too. To avoid "the spins" lie on your side rather than your back, and move slowly as you go from lying down to sitting and then standing.

Enjoy your freedom "Shake the pregnancy blahs by enjoying your last weeks of pre-baby freedom. Do all the things you may not have time for — movies, facials, romantic dinners with your mate — once your little one is here." —Bethany B.

3 Questions About Maternity leave

Q1.

Does my employer have to let me take maternity leave?

Not necessarily. Many employers are required by the Family and Medical Leave Act (FMLA) to allow their full-time employees (both men and women) 12 weeks of unpaid family leave after the birth or adoption of a child. But there are exceptions: Some part-time workers, newer employees, and employees of companies with fewer than 50 workers aren't covered by the FMLA. But even if you're not eligible for leave under the FMLA, you may be eligible under your state's provisions. To find out, check with your state's department of labor.

Actual paid "maternity leave" is unusual in the United States. Some companies offer new parents paid time off, up to six weeks in some cases. But most likely, you'll use a combination of short-term disability (STD), sick leave, vacation, personal days, and unpaid family leave to cobble together your maternity leave.

Q2.

How do I decide when to start my leave?

There's no "right time" to stop working. Some women start their leave in the seventh or eighth month while others work right up until delivery. You'll need to monitor your pregnancy to determine the right time to start maternity leave. If your practitioner puts you on bed rest, or complications develop that require you to be out of work before you give birth, you'll most likely be put on short-term disability if your state or company offers it.

Once your maternity leave is up, don't be surprised if it's hard to leave your baby and go back to work. Seventy-eight percent of new moms in a BabyCenter poll said they struggled with the decision to return to work, while only 22 percent said they were ready to go back.

Q3.

What's the best way to discuss these issues with my boss?

First, do your homework. Review your employee handbook, or contact a human resources representative who can inform you of your employer's formal policies regarding pregnancy and maternity leave. You may also want to question your co-workers who have already traveled this path.

Then, make a plan. Figure out how much time you think you'll want to take. If you're considering unpaid leave, think about how much time without a paycheck you can reasonably afford. Consider whether you'll want to take maternity leave in one block of time or whether you'd rather split it up over the year. Under the FMLA, you can use your 12 weeks anyway you want — all at once, a week at a time, some now, some later, etc. When making these decisions, consider your partner's schedule and benefits too. Some companies offer paid paternity leave, and your partner may qualify for leave under the FMLA as well.

To increase your chances of getting what you want, plan to offer your boss solutions rather than problems by having some ideas for how your work can be handled while you're away.

If you're not sure where to start, read about how seven new moms negotiated their maternity leaves and transitioned back to work. Seeing how other women made it work can be inspiring.

Find out exactly which questions you should ask your coworkers and human resources department with our maternity leave checklist, and get the full lowdown on maternity leave.

This Week's Activity:

Run some vital errands now. Here are some things you'll need in the first few weeks when it's almost impossible to go shopping:
• Diapers and wipes.
• Baby care items such as nail clippers, a thermometer, a bulb syringe, and a pacifier.
• Baby-friendly laundry detergent.
• Sanitary pads for you. (You'll bleed for a few weeks after delivery.)
• Thank-you cards and stamps.
• Paper towels and paper plates for easy cleanup after meals.


Source :babycenter.com

Your pregnancy: 27 weeks

How your baby's growing:

This week, your baby weighs almost 2 pounds (like a head of cauliflower) and is about 14 1/2 inches long with her legs extended. She's sleeping and waking at regular intervals, opening and closing her eyes, and perhaps even sucking her fingers. With more brain tissue developing, your baby's brain is very active now. While her lungs are still immature, they would be capable of functioning — with a lot of medical help — if she were to be born now. Chalk up any tiny rhythmic movements you may be feeling to a case of baby hiccups, which may be common from now on. Each episode usually lasts only a few moments, and they don't bother her, so just relax and enjoy the tickle.

See what your baby looks like this week.

Note: Every baby develops a little differently — even in the womb. Our information is designed to give you a general idea of your baby's development.

How your life's changing:

The second trimester is drawing to a close, but as your body gears up for the final lap, you may start noticing some new symptoms. Along with an aching back, for example, you may find that your leg muscles cramp up now and then. They're carrying extra weight, after all, and your expanding uterus is putting pressure on the veins that return blood from your legs to your heart as well as on the nerves leading from your trunk to your legs. Unfortunately, the cramps may get worse as your pregnancy progresses. Leg cramps are more common at night but can also happen during the day. When a cramp strikes, stretching the calf muscle should give you some relief. Straighten your leg and then gently flex your toes back toward your shin. Walking for a few minutes or massaging your calf sometimes helps, too.

It may be the furthest thing from your mind right now, but it's not too soon to think about family planning. You'll want to have made some decisions about postpartum birth control before your baby arrives. If you're considering a tubal ligation, be aware that most states require you to sign a consent form at least 30 days beforehand. So if you'd like the option of having the surgery during your postpartum hospital stay, don't wait too much longer to discuss it with your caregiver. (You can still change your mind later.)

Beyond orange juice "Need more vitamin C? Try red bell peppers! They have nearly twice the vitamin C of a navel orange, and a half cup is one of the five servings of fruits and vegetables you need each day." — Kayla B.

Surprising Facts: Symptoms you should never ignore

So many aches, pains, and strange feelings arise during pregnancy that it can be hard to decide what's normal and what warrants a call to your doctor or midwife. To complicate matters further, some symptoms may be more or less urgent depending on your particular situation or health history and on how far along you are in your pregnancy. Here's a rundown of symptoms that could be a sign of a problem. If you have any of these complaints, call your doctor or midwife immediately:

Before you reach 37 weeks:

• Pelvic pressure (a feeling that your baby is pushing down), lower back pain (especially if it's a new problem for you), menstrual-like cramping or abdominal pain, or more than four contractions in an hour (even if they don't hurt)

• An increase in vaginal discharge or a change in the type of discharge — if it becomes watery, mucus-like, or bloody (even if it's only pink or blood-tinged)

At any time:

• Your baby is moving or kicking less than usual

• Severe or persistent abdominal pain or tenderness

• Vaginal bleeding or spotting, or watery discharge

• Pain or burning when you urinate, or little or no urination

• Severe or persistent vomiting, or any vomiting accompanied by pain or fever

• Chills or a fever of 100 degrees Fahrenheit or higher

• Blurred or double vision, or seeing spots or "floaters"

• A severe or persistent headache, or any headache accompanied by blurred vision, slurred speech, or numbness

• Any swelling in your face or puffiness around your eyes, anything more than mild swelling in your fingers or hands, or severe or sudden swelling in your legs, feet, or ankles, or a rapid weight gain (more than 4 pounds in a week)

• Severe or persistent leg or calf pain that doesn't ease up when you flex your ankle and point your toes toward your nose, or one leg significantly more swollen than the other

• Trauma to your abdomen

• Fainting, frequent dizziness, rapid heartbeat, or palpitations

• Difficulty breathing, coughing up blood, or chest pain

• Severe constipation accompanied by abdominal pain or severe diarrhea that lasts more than 24 hours

• Persistent intense itching all over

• Any health problem that you'd ordinarily call your practitioner about, even if it's not pregnancy-related (like worsening asthma or a cold that gets worse rather than better)

Even if you don't see your symptom on the list above, trust your instincts and call your caregiver whenever you have a concern about your pregnancy. If there's a problem, you'll get help right away. If nothing's wrong, you'll be reassured.

This Week's Activity:

Sign up for a breastfeeding class. If you are a first-time mom and planning to breastfeed your baby, it's a good idea to take a breastfeeding class. Ask your caregiver or childbirth education teacher where you can take one. Or call La Leche League. It can help you locate breastfeeding resources in your area.


Source : babycenter.com

Your pregnancy: 25 weeks

How your baby's growing

Head to heels, your baby now measures about 13 1/2 inches. Her weight — a pound and a half — isn't much more than an average rutabaga, but she's beginning to exchange her long, lean look for some baby fat. As she does, her wrinkled skin will begin to smooth out and she'll start to look more and more like a newborn. She's also growing more hair — and if you could see it, you'd now be able to discern its color and texture.

See what's going on in your uterus this week.

Note: Every baby develops a little differently — even in the womb. Our information is designed to give you a general idea of your baby's development.

How your life's changing

Your baby's not the only one with more hair — your locks may look more full and lustrous than ever. It's not that you're growing more hair, but thanks to hormonal changes, the hair that you'd normally shed is sticking around longer than usual. Enjoy the fullness while you can — the extra hair will fall out after you give birth.

You may also notice that you can't move around as gracefully as before. Unless your caregiver has advised you otherwise, it's fine to continue to exercise, but follow a few safety rules: Don't work out when you're feeling overly tired and stop if you feel any pain, dizziness, or shortness of breath. Don't lie flat on your back and avoid contact sports as well as any exercise where you're apt to lose your balance. Be sure to drink plenty of water, and make time for both warm-up and cool-down periods.

When you have your glucose-screening test at 24 to 28 weeks, a second tube of blood may be taken at the same time to check for anemia. If blood tests show that you have iron-deficiency anemia (the most common type of anemia), your caregiver will probably recommend that you take an iron supplement.

Have you started thinking about baby names yet? Choosing a name is an important decision, but it should be a fun one, too. You may want to consider family history (Great Grandpa Zeb), favorite locations (Venice, where you honeymooned), or cherished literary or film characters (Greta, Meg, or Atticus, for example). Check out a couple of baby-name books to help you brainstorm, too.

Constipation cure: "To ease constipation, add oat or wheat bran to anything you can think of — cereal, yogurt, smoothies, or even spaghetti sauce." — Kristin

3 Questions About...Third trimester prenatal care

Q1.

How often will I see my caregiver in the third trimester?

Between 28 and 36 weeks, you'll see your caregiver every two weeks. One month before your due date, this will increase to once a week.

Q2.

What will she do at each appointment?

• Ask how you're feeling physically and emotionally and follow up on any issues raised at your last appointment. Among other things, she'll want to know if you're having contractions, vaginal bleeding, or unusual discharge; if you're having headaches; and if you're feeling anxious or depressed. Let her know if you have any symptoms that haven't been addressed.

• Ask about your baby's movements. She'll remind you to call if you sense that your baby has gotten less active. At some point, she may ask you to start counting your baby's movements for a set period of time each day.

• Weigh you and check your urine for signs of preeclampsia, urinary tract infections, and other problems. Take your blood pressure and check your ankles, hands, and face for swelling.

• Check your baby's heartbeat and do an abdominal exam to estimate your baby's size and position. She'll measure the distance between your pubic bone and the top of your uterus to see if your baby's growth rate seems normal.

• Possibly check your cervix. Don't expect a pelvic exam at every visit. Many caregivers don't do one unless they have a specific concern, such as preterm labor. Once you pass your due date, your provider will check your cervix to help decide whether (or when) to induce your labor.

• Tell you what to watch out for. She'll tell you about the signs of preterm labor and preeclampsia, and review other warning signs that should prompt a call. As your due date nears, she'll discuss the signs of labor and let you know when you should get in touch with her.

• Go over your labor and delivery questions. Make a list with your partner and bring it to a prenatal visit.

• Discuss postpartum decisions like whether you plan to breastfeed or circumcise your son. She'll also discuss your options for postpartum contraception. If you haven't found a doctor for your baby, your caregiver can give you some names.

Q3.

What tests are coming up?

Depending on your situation you may be offered:

• Hematocrit/hemoglobin: This blood test for anemia is usually repeated during the third trimester. (If you were tested when you took your glucose challenge test and the results were normal, it might not be repeated.)

• Gestational diabetes testing: If you have a normal glucose screening test between 24 and 28 weeks, consider yourself done. But if your screening results are abnormal and you haven't yet done the glucose tolerance test, you'll be tested now.

• Rh antibody screening: If you're Rh-negative, the antibody screen will be repeated (usually at the same time as your glucose challenge test) and you'll get an injection of Rh immune globulin at 28 weeks. In the unlikely case that some of your baby's blood gets into your bloodstream, the Rh immune globulin will protect you from developing antibodies that could pose a risk to future babies or even this one. (Note: if your baby's father takes a blood test and is found to be Rh-negative like you, you'll know that your baby is also Rh-negative so you won't need the Rh immune globulin.)

• Tests for sexually transmitted infections: If you're at high risk, your caregiver will do cervical cultures to check for chlamydia and gonorrhea, and your blood will be tested for syphilis. It's a wise idea to be retested for HIV as well if there's any chance you contracted it since your original test because treatment is available that dramatically reduces the risk of transmitting it to your baby.

• Group B strep test: Between 35 and 37 weeks, you'll be checked for group B streptococci (GBS) in your vagina and rectum. You won't be treated right away if the cultures are positive, because early treatment is no guarantee that the bacteria won't return. Instead, you'll be treated with IV antibiotics when you're in labor. (If you've previously given birth to a baby who had GBS, you can skip this test because you'll be given antibiotics in labor no matter what.)

• Biophysical profiles and nonstress tests: If you have certain pregnancy complications or you've passed your due date, these tests will be ordered to check on your baby.

This Week's Activity

Dedicate time to your partner this week. Treat your partner to a romantic surprise. Write down all the things you love about him, tell him why you think he'll be a great dad, or just go for a stroll while holding hands. Take time to connect on a physical and emotional level and celebrate what connects you and makes you love one another. Try to do something at least once a week that clearly communicates the importance of your partner in your life, says clinical psychologist Diane Sanford.


Source : babycenter.com