Monday, March 8, 2010

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WHETHER YOUR MEDICINE AFFECTS YOUR BABY, CHECK IT OUT

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.

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.


DOES YOUR DRUGS AFFETCT YOUR BABY, CHECK IT OUT

Your pregnancy: 40 weeks



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.

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.



HOW FDA (U.S.A) DEFINED YOUR DRUGS ON AFFECTION OF PREGNANCY

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.

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.


CHECK OUT YOUR PRESCRIPTION IS SAVE YOUR PREGNANCY AND YOUR BABY OR NOT

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.)

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.


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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.

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.





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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.

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.


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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.

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.




PHARMACY WIKIPEDIA, CHECK OUT YOUR MEDICINE

Your pregnancy: 34 weeks


How your baby's growing:


Your baby now weighs about 4 3/4 pounds (like your average cantaloupe) and is almost 18 inches long. Her fat layers — which will help regulate her body temperature once she's born — are filling her out, making her rounder. Her skin is also smoother than ever. Her central nervous system is maturing and her lungs are continuing to mature as well. If you've been nervous about preterm labor, you'll be happy to know that babies born between 34 and 37 weeks who have no other health problems generally do fine. They may need a short stay in the neonatal nursery and may have a few short-term health issues, but in the long run, they usually do as well as full-term babies.

How your life's changing:


By this week, fatigue has probably set in again, though maybe not with the same coma-like intensity of your first trimester. Your tiredness is perfectly understandable, given the physical strain you're under and the restless nights of frequent pee breaks and tossing and turning, while trying to get comfortable. Now's the time to slow down and save up your energy for labor day (and beyond). If you've been sitting or lying down for a long time, don't jump up too quickly. Blood can pool in your feet and legs, causing a temporary drop in your blood pressure when you get up that can make you feel dizzy.

If you notice itchy red bumps or welts on your belly and possibly your thighs and buttocks as well, you may have a condition called pruritic urticarial papules and plaques of pregnancy (PUPPP for short). Up to one percent of pregnant women develop PUPPP, which is harmless but can be quite uncomfortable. See your practitioner so she can make sure it's not a more serious problem, provide treatment to make you more comfortable, and refer you to a dermatologist if necessary. Also be sure to call her if you feel intense itchiness all over your body, even if you don't have a rash. It could signal a liver problem.


SIDE AFFECT ON YOUR BABY DUE TO IN PROPER DRUG USE

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.

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.



PHARMACY WIKIPEDIA, USEFULL TOOLS IN DAILY LIFE

Your pregnancy: 32 weeks

How your baby's growing:


By now, your baby weighs 3.75 pounds (pick up a large jicama) and is about 16.7 inches long, taking up a lot of space in your uterus. You're gaining about a pound a week and roughly half of that goes right to your baby. In fact, she'll gain a third to half of her birth weight during the next 7 weeks as she fattens up for survival outside the womb. She now has toenails, fingernails, and real hair (or at least respectable peach fuzz). Her skin is becoming soft and smooth as she plumps up in preparation for birth.

How your life's changing:


To accommodate you and your baby's growing needs, your blood volume has increased 40 to 50 percent since you got pregnant. With your uterus pushing up near your diaphragm and crowding your stomach, the consequences may be shortness of breath and heartburn. To help relieve your discomfort, try sleeping propped up with pillows and eating smaller meals more often.

You may have lower-back pain as your pregnancy advances. If you do, let your caregiver know right away, particularly if you haven't had back pain before, since it can be a sign of preterm labor.

Assuming it's not preterm labor that's ailing you, you can probably blame your growing uterus and hormonal changes for your aching back. Your expanding uterus shifts your center of gravity and stretches out and weakens your abdominal muscles, changing your posture and putting a strain on your back. Hormonal changes in pregnancy loosen your joints and the ligaments that attach your pelvic bones to your spine. This can make you feel less stable and cause pain when you walk, stand, sit for long periods, roll over in bed, get out of a low chair or the tub, bend, or lift things.





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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.

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.


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Your pregnancy: 30 weeks

How your baby's growing:


Your baby's about 15.7 inches long now, and she weighs almost 3 pounds (like a head of cabbage). A pint and a half of amniotic fluid surrounds her, but that volume will decrease as she gets bigger and takes up more room in your uterus. Her eyesight continues to develop, though it's not very keen; even after she's born, she'll keep her eyes closed for a good part of the day. When she does open them, she'll respond to changes in light but will have 20/400 vision — which means she can only make out objects a few inches from her face. (Normal adult vision is 20/20.)

How your life's changing:


You may be feeling a little tired these days, especially if you're having trouble sleeping. You might also feel clumsier than normal, which is perfectly understandable. Not only are you heavier, but the concentration of weight in your pregnant belly causes a shift in your center of gravity. Plus, thanks to hormonal changes, your ligaments are more lax, so your joints are looser, which may also contribute to your balance being a bit off. Also, this relaxation of your ligaments can actually cause your feet to spread permanently, so you may have to invest in some new shoes in a bigger size.

Remember those mood swings you had earlier in pregnancy? The combination of uncomfortable symptoms and hormonal changes can result in a return of those emotional ups and downs. It's normal to worry about what your labor will be like or whether you'll be a good parent. But if you can't shake the blues or feel increasingly irritable or agitated, talk to your doctor or midwife. You may be among the 1 in 10 expectant women who battle depression during pregnancy. Also let your caregiver know if you're frequently nervous or anxious.


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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.

How your life's changing:


Four exercises to ease aches and help with labor

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.


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Your pregnancy: 28 weeks

How your baby's growing:


By this week, your baby weighs two and a quarter pounds (like a Chinese cabbage) and measures 14.8 inches from the top of her head to her heels. She can blink her eyes, which now sport lashes. With her eyesight developing, she may be able to see the light that filters in through your womb. She's also developing billions of neurons in her brain and adding more body fat in preparation for life in the outside world.

How your life's changing:


You're in the home stretch! The third and final trimester starts this week. If you're like most women, you'll gain about 11 pounds this trimester.

At this point, you'll likely visit your doctor or midwife every two weeks. Then, at 36 weeks, you'll switch to weekly visits. Depending on your risk factors, your practitioner may recommend repeating blood tests for HIV and syphilis now, as well as doing cultures for chlamydia and gonorrhea, to be certain of your status before delivery. Also, if your glucose screening test result was high and you haven't yet had follow-up testing, you'll soon be given the 3-hour glucose tolerance test. And if the blood work done at your first prenatal visit showed that you're Rh negative, you'll get an injection of Rh immunoglobulin to prevent your body from developing antibodies that could attack your baby's blood. (If your baby is Rh positive, you'll receive another shot of Rh immunoglobulin after you give birth.)

Around this time, some women feel an unpleasant "creepy-crawly" sensation in their lower legs and an irresistible urge to move them while trying to relax or sleep. If this sensation is at least temporarily relieved when you move, you may have what's known as restless legs syndrome (RLS). No one knows for sure what causes RLS, but it's relatively common among expectant mothers. Try stretching or massaging your legs, and cut down on caffeine, which can make the symptoms worse. Ask your caregiver if you should try iron supplements, which can sometimes relieve RLS.


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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.

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.)


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Your pregnancy: 26 weeks

How your baby's growing:


The network of nerves in your baby's ears is better developed and more sensitive than before. He may now be able to hear both your voice and your partner's as you chat with each other. He's inhaling and exhaling small amounts of amniotic fluid, which is essential for the development of his lungs. These so-called breathing movements are also good practice for when he's born and takes that first gulp of air. And he's continuing to put on baby fat. He now weighs about a pound and two-thirds and measures 14 inches (an English hothouse cucumber) from head to heel. If you're having a boy, his testicles are beginning to descend into his scrotum — a trip that will take about two to three days.

How your life's changing:


Are you rushing around trying to get to childbirth classes and prepare your baby's room while still taking care of all your other daily tasks? Make sure that you also continue to eat well and get plenty of rest. Around this time, your blood pressure may be increasing slightly, although it's probably still lower than it was before you got pregnant. (Typically, blood pressure falls toward the end of the first trimester, and it tends to reach a low at about 22 to 24 weeks.)

Preeclampsia — a serious disorder characterized by high blood pressure and protein in your urine — most often shows up after 37 weeks, but it can happen earlier so it's important to be aware of the warning signs of this condition. Call your caregiver if you have swelling in your face or puffiness around your eyes, more than slight swelling of your hands, excessive or sudden swelling of your feet or ankles, or rapid weight gain (more than 4 pounds in a week). With more severe preeclampsia, you may experience other symptoms. Let your caregiver know immediately if you have a severe or persistent headache, vision changes (including double or blurred vision, seeing spots or flashing lights, sensitivity to light, or temporary loss of vision), intense pain or tenderness in your upper abdomen, or vomiting.

If your lower back seems a little achy lately, you can thank both your growing uterus — which shifts your center of gravity, stretches out and weakens your abdominal muscles, and may be pressing on a nerve — as well as hormonal changes that loosen your joints and ligaments. Plus, the extra weight you're carrying means more work for your muscles and increased stress on your joints, which is why you may feel worse at the end of the day. Walking, standing, or sitting for long periods, as well as bending and lifting can all put a strain on your back. A warm bath or hot compress might bring relief. (Some women, though, find cool compresses more comforting.) Try to maintain good posture during the day, avoid activities that require bending and twisting at the same time, take frequent breaks when sitting or standing, and sleep on your side with one or both knees bent with a pillow between your legs, using another pillow (or wedge) to support your abdomen.


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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.

How your life's changing


Is it safe to walk through airport screening machines while I'm pregnant?

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.


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Your pregnancy: 24 weeks

How your baby's growing:


Your baby's growing steadily, having gained about 4 ounces since last week. That puts him at just over a pound. Since he's almost a foot long (picture an ear of corn), he cuts a pretty lean figure at this point, but his body is filling out proportionally and he'll soon start to plump up. His brain is also growing quickly now, and his taste buds are continuing to develop. His lungs are developing "branches" of the respiratory "tree" as well as cells that produce surfactant, a substance that will help his air sacs inflate once he hits the outside world. His skin is still thin and translucent, but that will start to change soon.

How your life's changing:


In the past few weeks, the top of your uterus has risen above your belly button and is now about the size of a soccer ball.

Most women have a glucose screening test (also called a glucose challenge test or GCT) between now and 28 weeks. This test checks for gestational diabetes, a pregnancy-related high-blood-sugar condition. Untreated diabetes increases your risk of having a difficult vaginal delivery or needing a cesarean section because it causes your baby to grow too large, especially in his upper body. It also raises your baby's odds for other complications like low blood sugar right after birth. A positive result on your GCT doesn't mean you have gestational diabetes, but it does mean that you'll need to take the glucose tolerance test (GTT) to find out for sure.

Finally, if you don't already know how to spot the signs of preterm labor, now's the time to learn. Contact your caregiver immediately if you notice any of the signs mentioned below.


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Your pregnancy: 23 weeks

How your baby's growing:


Turn on the radio and sway to the music. With her sense of movement well developed by now, your baby can feel you dance. And now that she's more than 11 inches long and weighs just over a pound (about as much as a large mango), you may be able to see her squirm underneath your clothes. Blood vessels in her lungs are developing to prepare for breathing, and the sounds that your baby's increasingly keen ears pick up are preparing her for entry into the outside world. Loud noises that become familiar now — such as your dog barking or the roar of the vacuum cleaner — probably won't faze her when she hears them outside the womb.

How your life's changing:


You may notice that your ankles and feet start to swell a bit in the coming weeks or months, especially at the end of the day or during the heat of summer. Sluggish circulation in your legs — coupled with changes in your blood chemistry that may cause some water retention — may result in swelling, also known as edema. Your body will get rid of the extra fluid after you have your baby, which is why you'll pee frequently and sweat a lot for a few days after delivery. In the meantime, lie on your left side or put your feet up when you can, stretch out your legs when you sit, and avoid sitting — or standing — in one place for long periods. Also, try to exercise regularly to increase circulation, and wear support stockings (put them on first thing in the morning) and roomy, comfortable shoes. You may be tempted to skimp on liquids to combat swelling, but you need to drink plenty of water because staying hydrated actually helps prevent fluid retention. While a certain amount of edema in your lower extremities is normal during pregnancy, excessive swelling may be a sign of a serious condition called preeclampsia. Be sure to call your midwife or doctor if you have severe or sudden swelling of your feet or ankles, more than slight swelling of your hands, swelling in your face, or puffiness around your eyes.


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Your pregnancy: 22 weeks

How your baby's growing:


At 11 inches (the length of a spaghetti squash) and almost 1 pound, your baby is starting to look like a miniature newborn. His lips, eyelids, and eyebrows are becoming more distinct, and he's even developing tiny tooth buds beneath his gums. His eyes have formed, but his irises (the colored part of the eye) still lack pigment. If you could see inside your womb, you'd be able to spot the fine hair (lanugo) that covers his body and the deep wrinkles on his skin, which he'll sport until he adds a padding of fat to fill them in. Inside his belly, his pancreas — essential for the production of some important hormones — is developing steadily.

How your life's changing:


At this point, you may find your belly becoming a hand magnet. It's perfectly okay to tell folks who touch your tummy that you'd rather they didn't. And if people are telling you that you look smaller or bigger than you should at this point, remember that each woman grows — and shows — at her own rate. What's important is that you see your practitioner for regular visits so she can make sure your baby's growth is on track.

You may start to notice stretch marks on your abdomen as it expands to accommodate your growing baby. At least half of all pregnant women will develop stretch marks by the time they give birth. These small streaks of differently textured skin can range from pink to dark brown (depending on your skin color). Although they most commonly appear on your tummy, stretch marks may also show up on your buttocks, thighs, hips, and breasts. There's no proof that lotion helps prevent stretch marks, but keeping your skin moisturized may help with any itching.



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Your pregnancy: 21 weeks

How your baby's growing:

Your baby now weighs about three-quarters of a pound and is approximately 10 1/2 inches long — the length of a carrot. You may soon feel like she's practicing martial arts as her initial fluttering movements turn into full-fledged kicks and nudges. You may also discover a pattern to her activity as you get to know her better. In other developments, your baby's eyebrows and lids are present now, and if you're having a girl, her vagina has begun to form as well

How your life's changing:


You're probably feeling pretty comfortable these days. You're not too big yet, and the usual discomforts associated with early pregnancy are, for the most part, gone. If you're feeling good, relax and enjoy it while you can — the third trimester may bring with it a new crop of complaints.

That's not to say you won't have some minor glitches to deal with now. For example, increased oil production may contribute to the development (or worsening) of acne. If that's the case, be diligent about washing well with a gentle soap or cleanser twice a day, and make sure that any moisturizer or make-up you use is oil-free. Don't take any oral acne medications — some are very hazardous during pregnancy — or use any topical acne products without first checking with your practitioner.

You're also more prone to varicose veins now. As your pregnancy progresses, there's increasing pressure on the veins in your legs; higher progesterone levels, which may cause the walls of your veins to relax, can make the problem worse. You're more likely to get varicose veins if other family members have them. Also, they tend to get worse with each successive pregnancy and as you age. To help prevent or minimize varicose veins, exercise daily, prop up your feet and legs whenever possible, sleep on your left side, and wear maternity support hose.

You may also notice so-called spider veins (a group of tiny blood vessels near the surface of your skin), particularly on your ankles, legs, or face. They may have a spider- or sunburst-like pattern with little branches radiating out from the center, they may look like the branches of a tree, or they may be a group of separate thin lines with no particular pattern. Though they may be a bit unsightly, spider veins don't cause discomfort and usually disappear after delivery.


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Your pregnancy: 20 weeks

How your baby's growing:


Your baby weighs about 10 1/2 ounces now. He's also around 6 1/2 inches long from head to bottom and about 10 inches from head to heel — the length of a banana. (For the first 20 weeks, when a baby's legs are curled up against his torso and hard to measure, measurements are taken from the top of his head to his bottom — the "crown to rump" measurement. After 20 weeks, he's measured from head to toe.)

He's swallowing more these days, which is good practice for his digestive system. He's also producing meconium, a black, sticky by-product of digestion. This gooey substance will accumulate in his bowels, and you'll see it in his first soiled diaper (some babies pass meconium in the womb or during delivery).

How your life's changing:


Congratulations! You've hit the halfway mark in your pregnancy. The top of your uterus is about level with your belly button, and you've likely gained around 10 pounds. Expect to gain another pound or so each week from now on. (If you started your pregnancy underweight, you may need to gain a bit more; if you were overweight, perhaps a bit less.) Make sure you're getting enough iron, a mineral that's used primarily to make hemoglobin (the part of your red blood cells that carries oxygen). During pregnancy, your body needs more iron to keep up with your expanding blood volume, as well as for your growing baby and the placenta. Red meat is one of the best sources of iron for pregnant women. Poultry (especially the dark meat) and shellfish also contain iron. Some common non-meat sources of iron include legumes, soy-based products, spinach, prune juice, raisins, and iron-fortified cereals.

If you haven't already signed up for a childbirth education class, you may want to look into one, especially if you're a first-timer. A structured class will help prepare you and your partner for the rigors of labor and delivery. Most hospitals and birth centers offer classes, either as weekly meetings or as a single intensive, one-day session. Many communities have independent instructors as well. Ask your friends, family members, or caregiver for recommendations.


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Your pregnancy: 19 weeks

How your baby's growing:


Your baby's sensory development is exploding! Her brain is designating specialized areas for smell, taste, hearing, vision, and touch. Some research suggests that she may be able to hear your voice now, so don't be shy about reading aloud, talking to her, or singing a happy tune if the mood strikes you.

Your baby weighs about 8 1/2 ounces and measures 6 inches, head to bottom — about the size of a large heirloom tomato. Her arms and legs are in the right proportions to each other and the rest of her body now. Her kidneys continue to make urine and the hair on her scalp is sprouting. A waxy protective coating called the vernix caseosa is forming on her skin to prevent it from pickling in the amniotic fluid.

How your life's changing:


Think you're big now? You'll start growing even faster in the weeks to come. As a result, you may notice some achiness in your lower abdomen or even an occasional brief, stabbing pain on one or both sides — especially when you shift position or at the end of an active day. Most likely, this is round ligament pain. The ligaments that support your uterus are stretching to accommodate its increasing weight. This is nothing to be alarmed about, but call your practitioner if the pain continues even when you're resting or becomes severe.

You may be noticing some skin changes, too. Are the palms of your hands red? Nothing to worry about — it's from the extra estrogen. You may also have patches of darkened skin caused by a temporary increase in pigment. When these darker patches appear on your upper lip, cheeks, and forehead, they're called chloasma, or the "mask of pregnancy." You may also notice some darkening of your nipples, freckles, scars, underarms, inner thighs, and vulva. That darkened line running from your belly button to your pubic bone is called the linea nigra, or "dark line."

These darkened spots will probably fade shortly after delivery. In the meantime, protect yourself from the sun, which intensifies the pigment changes. Cover up, wear a brimmed hat, and use sunscreen when you're outdoors. And if you're self-conscious about your "mask," a little concealing makeup can work wonders.



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Your pregnancy: 18 weeks

How your baby's growing:


Head to rump, your baby is about 5 1/2 inches long (about the length of a bell pepper) and he weighs almost 7 ounces. He's busy flexing his arms and legs — movements that you'll start noticing more and more in the weeks ahead. His blood vessels are visible through his thin skin, and his ears are now in their final position, although they're still standing out from his head a bit. A protective covering of myelin is beginning to form around his nerves, a process that will continue for a year after he's born. If you're having a girl, her uterus and fallopian tubes are formed and in place. If you're having a boy, his genitals are noticeable now, but he may hide them from you during an ultrasound
 
How your life's changing:


Hungry? An increase in appetite is pretty common about now. Make it count by choosing meals and snacks that are rich in nutrients instead of empty calories (chips, French fries, candy, and other sweets). Bigger, more comfortable clothes are a must now as your appetite and waistline grow.

Your cardiovascular system is undergoing dramatic changes, and during this trimester your blood pressure will probably be lower than usual. Don't spring up too fast from a lying or sitting position or you might feel a little dizzy.

From now on, when you do lie down, it's best to lie on your side — or at least partly tilted to one side. (When you lie flat on your back, your uterus can compress a major vein, leading to decreased blood return to your heart.) Try placing a pillow behind you or under your hip or upper leg for comfort.

If you haven't already had a second-trimester ultrasound, you'll probably have one soon. This painless procedure helps your practitioner check how your baby's growing, screen for certain birth defects, check the placenta and umbilical cord, determine whether the due date you're working with is accurate, and see how many babies you're carrying. During the exam, you might see your baby moving around or sucking his thumb. Bring your partner along, and be sure to ask for a printout for your baby's first photo album!

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Your pregnancy: 17 weeks

How your baby's growing:


Your baby's skeleton is changing from soft cartilage to bone, and the umbilical cord — her lifeline to the placenta — is growing stronger and thicker. Your baby weighs 5 ounces now (about as much as a turnip), and she's around 5 inches long from head to bottom. She can move her joints, and her sweat glands are starting to develop
 
How your life's changing:


Starting to feel a bit off balance? As your belly grows, your center of gravity changes, so you may begin to occasionally feel a little unsteady on your feet. Try to avoid situations with a high risk of falling. Wear low-heeled shoes to reduce your risk of taking a tumble; trauma to your abdomen could be dangerous for you and your baby. You'll also want to be sure to buckle up when you're in a car — keep the lap portion of the seat belt under your belly, drawn snugly across your hips, and also use the shoulder harness, which should fit snugly between your breasts.

You may also notice your eyes becoming drier. Using over-the-counter lubricating drops may help. If your contact lenses become uncomfortable, try wearing them for shorter stretches of time. If you still have discomfort, switch to glasses until after you give birth.


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Your pregnancy: 16 weeks

How your baby's growing:


Get ready for a growth spurt. In the next few weeks, your baby will double his weight and add inches to his length. Right now, he's about the size of an avocado: 4 1/2 inches long (head to rump) and 3 1/2 ounces. His legs are much more developed, his head is more erect than it has been, and his eyes have moved closer to the front of his head. His ears are close to their final position, too. The patterning of his scalp has begun, though his locks aren't recognizable yet. He's even started growing toenails. And there's a lot happening inside as well. For example, his heart is now pumping about 25 quarts of blood each day, and this amount will continue to increase as your baby continues to develop.

How your life's changing:


The top of your uterus is about halfway between your pubic bone and your navel, and the round ligaments that support it are thickening and stretching as it grows. You're probably feeling a whole lot better as you settle into pregnancy, too. Less nausea, fewer mood swings, and "glowing" skin contribute to an overall sense of well-being.

Soon you'll experience one of the most wonderful moments of pregnancy — feeling your baby move. While some women notice "quickening" as early as 16 weeks, many don't feel their baby move until about 18 weeks or more. (And if this is your first baby, don't be too impatient — you may not be aware of your baby's movements until 20 weeks or so.) The earliest movements may feel like little flutters, gas bubbles, or even like popcorn popping. Over the following weeks they'll grow stronger and you'll be able to feel them much more frequently.


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Your pregnancy: 15 weeks

How your baby's growing:


Your growing baby now measures about 4 inches long, crown to rump, and weighs in at about 2 1/2 ounces (about the size of an apple). She's busy moving amniotic fluid through her nose and upper respiratory tract, which helps the primitive air sacs in her lungs begin to develop. Her legs are growing longer than her arms now, and she can move all of her joints and limbs. Although her eyelids are still fused shut, she can sense light. If you shine a flashlight at your tummy, for instance, she's likely to move away from the beam. There's not much for your baby to taste at this point, but she is forming taste buds. Finally, if you have an ultrasound this week, you may be able to find out whether your baby's a boy or a girl! (Don't be too disappointed if it remains a mystery, though. Nailing down your baby's sex depends on the clarity of the picture and on your baby's position. He or she may be modestly curled up or turned in such a way as to "hide the goods.")

How your life's changing:


You've probably gained about 5 pounds by now (a little more or less is fine, too) and are well into the swing of your pregnancy, but you may still be surprised by an unexpected symptom now and then. If your nose is stuffed up, for instance, you can probably chalk it up to the combined effect of hormonal changes and increased blood flow to your mucous membranes. This condition is so common, there's even a name for it: "rhinitis of pregnancy." Some pregnant women also suffer nosebleeds as a result of increased blood volume and blood vessel expansion in the nose.

If you're having amniocentesis, it'll most likely happen between now and 18 weeks. This test can identify hundreds of genetic and chromosomal disorders. If you're getting very anxious while waiting for the results, it may help to know that most women who undergo amniocentesis get good news about their babies — bringing welcome relief from their worries.

Don't be surprised if you and your partner are feeling a little stressed out these days. Many pregnant couples worry about their baby's health and how they'll handle the changes ahead. But with physical discomforts on the wane and energy on the rise, this is also a wonderful trimester for most women.
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Your pregnancy: 14 weeks

How your baby's growing:


This week's big developments: Your baby can now squint, frown, grimace, pee, and possibly suck his thumb! Thanks to brain impulses, his facial muscles are getting a workout as his tiny features form one expression after another. His kidneys are producing urine, which he releases into the amniotic fluid around him — a process he'll keep up until birth. He can grasp, too, and if you're having an ultrasound now, you may even catch him sucking his thumb.

In other news: Your baby's stretching out. From head to bottom, he measures 3 1/2 inches — about the size of a lemon — and he weighs 1 1/2 ounces. His body's growing faster than his head, which now sits upon a more distinct neck. By the end of this week, his arms will have grown to a length that's in proportion to the rest of his body. (His legs still have some lengthening to do.) He's starting to develop an ultra-fine, downy covering of hair, called lanugo, all over his body. Your baby's liver starts making bile this week — a sign that it's doing its job right — and his spleen starts helping in the production of red blood cells. Though you can't feel his tiny punches and kicks yet, your little pugilist's hands and feet (which now measure about 1/2 inch long) are more flexible and active.

How your life's changing:


Welcome to your second trimester! Your energy is likely returning, your breasts may be feeling less tender, and your queasiness may have completely abated by now. If not, hang on — chances are good it will soon be behind you (although an unlucky few will still feel nauseated months from now).

The top of your uterus is a bit above your pubic bone, which may be enough to push your tummy out a tad. Starting to show can be quite a thrill, giving you and your partner visible evidence of the baby you've been waiting for. Take some time to plan, daydream, and enjoy this amazing time. It's normal to worry a bit now and then, but try to focus on taking care of yourself and your baby, and having faith that you're well equipped for what's ahead.

Decision Guide: Should you find out the sex of your baby?

Boy, girl — or big surprise? Sixty-four percent of mothers-to-be in a BabyCenter poll said they wanted to find out the sex of their baby ahead of time, while the rest preferred to wait. "We decided that the surprise of 'it's a boy!' or 'it's a girl!' is the same surprise at 5 months as it is at the birth," said Jessica. Michael disagreed: "I think the old-fashioned way is the best. Finding out before birth is like opening your Christmas presents before Christmas!" If you're still on the fence, here's a look at the pros and cons of each side. A word of caution: If you want to keep your baby's sex a secret, let your provider and the ultrasound technician know right away so they don't inadvertently blurt it out in the middle of an ultrasound exam or while reviewing your test results.


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Your pregnancy: 13 weeks

How your baby's growing:

Fingerprints have formed on your baby's tiny fingertips, her veins and organs are clearly visible through her still-thin skin, and her body is starting to catch up with her head — which makes up just a third of her body size now. If you're having a girl, she now has more than 2 million eggs in her ovaries. Your baby is almost 3 inches long (the size of a medium shrimp) and weighs nearly an ounce.

How your life's changing:


This is the last week of your first trimester, and your risk of miscarriage is now much lower than earlier in pregnancy. Next week marks the beginning of your second trimester, a time of relative comfort for many women who see early pregnancy symptoms such as morning sickness and fatigue subside. More good news: Many couples also notice a distinct libido lift around this time. Birth is still months away, but your breasts may have already started making colostrum, the nutrient-rich fluid that feeds your baby for the first few days after birth, before your milk starts to flow


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Your pregnancy: 12 weeks

How your baby's growing:


The most dramatic development this week: reflexes. Your baby's fingers will soon begin to open and close, his toes will curl, his eye muscles will clench, and his mouth will make sucking movements. In fact, if you prod your abdomen, your baby will squirm in response, although you won't be able to feel it. His intestines, which have grown so fast that they protrude into the umbilical cord, will start to move into his abdominal cavity about now, and his kidneys will begin excreting urine into his bladder.

Meanwhile, nerve cells are multiplying rapidly, and in your baby's brain, synapses are forming furiously. His face looks unquestionably human: His eyes have moved from the sides to the front of his head, and his ears are right where they should be. From crown to rump, your baby-to-be is just over 2 inches long (about the size of a lime) and weighs half an ounce.

How your life's changing:


Your uterus has grown to the point where your healthcare provider can now feel the top of it (the fundus) low in your abdomen, just above your pubic bone. You may already be into maternity clothes, especially if this isn't your first pregnancy. If you're still fairly small and not yet ready for maternity clothes, you've no doubt noticed that your waist is thickening and that you're more comfortable in loose, less restrictive clothing.

You may begin to feel heartburn (also called acid indigestion), a burning sensation that often extends from the bottom of your breastbone to your lower throat. Many women get heartburn for the first time during pregnancy, and those who've previously had bouts of heartburn may find that it gets worse. During pregnancy, the placenta produces a lot of the hormone progesterone, which relaxes the valve that separates the esophagus from the stomach. Particularly when you're lying down, gastric acid can seep back up the pipe, which causes the uncomfortable burning sensation. For many women the problem doesn't begin (or get worse) until later in pregnancy, when your growing uterus starts to push up on your stomach. The discomfort may range from mildly annoying to intense and distracting.


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Your pregnancy: 11 weeks

How your baby's growing:

Your baby, just over 1 1/2 inches long and about the size of a fig, is now almost fully formed. Her hands will soon open and close into fists, tiny tooth buds are beginning to appear under her gums, and some of her bones are beginning to harden.

She's already busy kicking and stretching, and her tiny movements are so effortless they look like water ballet. These movements will become more frequent as her body grows and becomes more developed and functional. You won't feel your baby's acrobatics for another month or two — nor will you notice the hiccupping that may be happening now that her diaphragm is forming.

How your life's changing:


If you're like most women, you're feeling a bit more energetic now and your nausea may be starting to wane. Unfortunately, you may also be suffering from constipation (caused by hormonal changes, which can slow digestion) and heartburn (hormones again, relaxing the valve between your stomach and esophagus). Just remember, all this discomfort is for a good cause.

Don't worry if nausea has made it impossible for you to eat a wide variety of healthy foods or if you haven't put on much weight yet (most women gain just 2 to 5 pounds during the first trimester). Your appetite will likely return soon, and you'll start to gain about a pound a week.

Learn which of your symptoms are normal and which are a sign that something might be wrong. You're probably also wondering things like, Can I keep going to dance class? Could the air bags in my car hurt my baby? Which cold medications are safe to take now? Find out what's safe and what's not during pregnancy.


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Your pregnancy: 10 weeks

How your baby's growing:


Though he's barely the size of a kumquat — a little over an inch or so long, crown to bottom — and weighs less than a quarter of an ounce, your baby has now completed the most critical portion of his development. This is the beginning of the so-called fetal period, a time when the tissues and organs in his body rapidly grow and mature.

He's swallowing fluid and kicking up a storm. Vital organs — including his kidneys, intestines, brain, and liver (now making red blood cells in place of the disappearing yolk sac) — are in place and starting to function, though they'll continue to develop throughout your pregnancy.

If you could take a peek inside your womb, you'd spot minute details, like tiny nails forming on fingers and toes (no more webbing) and peach-fuzz hair beginning to grow on tender skin.

In other developments: Your baby's limbs can bend now. His hands are flexed at the wrist and meet over his heart, and his feet may be long enough to meet in front of his body. The outline of his spine is clearly visible through translucent skin, and spinal nerves are beginning to stretch out from his spinal cord. Your baby's forehead temporarily bulges with his developing brain and sits very high on his head, which measures half the length of his body. From crown to rump, he's about 1 1/4 inches long. In the coming weeks, your baby will again double in size — to nearly 3 inches.

How your life's changing:


At your next prenatal visit, you may be able to hear your baby's rapid heartbeat with the help of a Doppler stethoscope, a handheld ultrasound device that your practitioner places on your belly. Many women say that the beating of their baby's tiny heart sounded like the thunder of galloping horses and hearing it for the first time was very moving.

Before you got pregnant, your uterus was the size of a small pear. By this week, it's as big as a grapefruit. You may or may not be ready for maternity wear now. Even if you're not there yet, your regular clothes are probably feeling uncomfortably tight and your blossoming breasts are straining the seams of your bra. The thickening in your midsection is most likely due to slight weight gain and bloating. If you're between regular and maternity clothes, pants and skirts with forgiving elastic waistbands (or low-rise waistlines that sit below your belly) will provide some much-needed comfort.

Depending on your level of fitness, you can most likely participate in a wide range of activities during pregnancy. Swimming and walking are excellent choices for the whole nine months. Exercise promotes muscle tone, strength, and endurance — three qualities that can help you carry the weight you gain during pregnancy, prepare you for the physical stress of labor, and make it easier to get back into shape after your baby is born. (Unfortunately, there's no evidence that regular exercise shortens labor.)


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Your pregnancy: 9 weeks

How your baby's growing:


Your new resident is nearly an inch long — about the size of a grape — and weighs just a fraction of an ounce. She's starting to look more and more human. Her essential body parts are accounted for, though they'll go through plenty of fine-tuning in the coming months. Other changes abound: Your baby's heart finishes dividing into four chambers, and the valves start to form — as do her tiny teeth. The embryonic "tail" is completely gone. Your baby's organs, muscles, and nerves are kicking into gear. The external sex organs are there but won't be distinguishable as male or female for another few weeks. Her eyes are fully formed, but her eyelids are fused shut and won't open until 27 weeks. She has tiny earlobes, and her mouth, nose, and nostrils are more distinct. The placenta is developed enough now to take over most of the critical job of producing hormones. Now that your baby's basic physiology is in place, she's poised for rapid weight gain.

How your life's changing:


You still may not look pregnant even if your waist is thickening a bit. You probably feel pregnant, though. Not only are morning sickness and other physical symptoms out in full force for most women, but you may feel like an emotional pinball as well.

Mood swings are common now — it's perfectly normal to feel alternately elated and terrified about becoming a parent. Try to cut yourself some slack. Most women find that moodiness flares up at around six to ten weeks, eases up in the second trimester, and then reappears as pregnancy winds to a close.


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Your pregnancy: 8 weeks

How your baby's growing:


New this week: Webbed fingers and toes are poking out from your baby's hands and feet, his eyelids practically cover his eyes, breathing tubes extend from his throat to the branches of his developing lungs, and his "tail" is just about gone. In his brain, nerve cells are branching out to connect with one another, forming primitive neural pathways. You may be daydreaming about your baby as one sex or the other, but the external genitals still haven't developed enough to reveal whether you're having a boy or a girl. Either way, your baby — about the size of a kidney bean — is constantly moving and shifting, though you still can't feel it.

How your life's changing:


You may notice that your bra is getting more snug. Soon you'll likely need a larger size with better support. Rising levels of hormones cause breast growth and other tissue changes, all in preparation for lactation. Your breasts may continue to grow throughout pregnancy. Don't be surprised if you go up a cup size or two, especially if it's your first baby. Keep this in mind, and allow for room to grow when investing in a new bra.

Feeling fatigued? Hormonal changes — in particular, a dramatic rise in progesterone — may be contributing to your sluggishness. Nausea and vomiting can certainly cost you energy, too. And you may be having trouble getting a good night's sleep at this point, especially if you're uncomfortable or find you need to get up to pee.

Walking to beat fatigue "Taking a short 15- to 20-minute walk helped me cope with the overwhelming fatigue that hit me in the first trimester. It was the only way I made it through a day at work without a nap!" —Gabriela

Decision Guide: Which prenatal tests are for you?

Your healthcare provider will offer you a range of genetic screening and diagnostic tests during your pregnancy. Some are simple blood tests, while others involve more invasive procedures — and all are optional. Before you agree to any test, ask your caregiver to explain what it is, how it's done, whether the test itself is risky in any way, and what the results will tell you. Many prenatal tests are for screening rather than diagnostic purposes. Screening tests give you a sense of your risk for certain conditions. But only a diagnostic test can tell you for sure whether your baby has a problem. Here are your options during the first trimester:

First-trimester combined screening test: This relatively new screening test combines a nuchal fold scan (using ultrasound to measure the clear space in the tissue at the back of your developing baby's neck) with a blood test to measure two proteins. The scan is performed between 11 weeks of pregnancy through the end of 13 weeks, and the blood test may be done at the same time or possibly a few weeks earlier. First-trimester combined screening gives you information about your baby's odds of having Down syndrome and may tell you whether your baby's at higher risk for a few other problems as well. Although it's not diagnostic, the screening is essentially risk-free and may help you decide whether you want invasive diagnostic testing such as chorionic villus sampling (CVS) or amniocentesis, which slightly increase the risk of miscarriage.

Chorionic villus sampling (CVS): This diagnostic test involves collecting cells from the placenta, which are then sent to a lab for genetic analysis. CVS can identify whether your baby has any of hundreds of chromosomal abnormalities and other genetic disorders. It's done in the first trimester, usually between 11 and 12 weeks, making it an earlier alternative to another diagnostic genetic test called amniocentesis, which is done between 16 and 20 weeks.


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Your pregnancy: 7 weeks

How your baby's growing:


The big news this week: Hands and feet are emerging from developing arms and legs — although they look more like paddles at this point than the tiny, pudgy extremities you're daydreaming about holding and tickling. Technically, your baby is still considered an embryo and has something of a small tail, which is an extension of her tailbone. The tail will disappear within a few weeks, but that's the only thing getting smaller. Your baby has doubled in size since last week and now measures half an inch long, about the size of a blueberry.

If you could see inside your womb, you'd spot eyelid folds partially covering her peepers, which already have some color, as well as the tip of her nose and tiny veins beneath parchment-thin skin. Both hemispheres of your baby's brain are growing, and her liver is churning out red blood cells until her bone marrow forms and takes over this role. She also has an appendix and a pancreas, which will eventually produce the hormone insulin to aid in digestion. A loop in your baby's growing intestines is bulging into her umbilical cord, which now has distinct blood vessels to carry oxygen and nutrients to and from her tiny body.

How your life's changing:


Your uterus has doubled in size in the past five weeks, and eating may feel like a chore — or worse — thanks to morning sickness, which by now may be in full swing. (If you're feeling fine, don't worry — you're lucky!)

You may need to pee more than usual, too, thanks to your increasing blood volume and the extra fluid being processed through your kidneys. (By now, you already have about 10 percent more blood than you did before you were pregnant. And by the end of your pregnancy, you'll have 40 to 45 percent more blood running through your veins to meet the demands of your full-term baby.) As your uterus grows, pressure on your bladder will send you to the bathroom as well.

About half of the women who feel nauseated during the first trimester will find complete relief by about 14 weeks. For most of the rest, it'll take another month or so for the queasiness to ease up. It's unlikely, though, that the need to pee more than usual will ease up. In fact, research shows that both the frequency and volume of urine tends to increase over the course of pregnancy.




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Your pregnancy: 6 weeks

How your baby's growing:


This week's major developments: The nose, mouth, and ears that you'll spend so much time kissing in eight months are beginning to take shape. If you could see into your uterus, you'd find an oversize head and dark spots where your baby's eyes and nostrils are starting to form. His emerging ears are marked by small depressions on the sides of the head, and his arms and legs by protruding buds. His heart is beating about 100 to 160 times a minute — almost twice as fast as yours — and blood is beginning to course through his body. His intestines are developing, and the bud of tissue that will give rise to his lungs has appeared. His pituitary gland is forming, as are the rest of his brain, muscles, and bones. Right now, your baby is a quarter of an inch long, about the size of a lentil bean.

How your life's changing:


You may find yourself developing a bit of a split personality — feeling moody one day and joyful the next. Unsettling as this is (especially if you pride yourself on being in control), what you're going through is normal. Ricocheting emotions are caused partly by fluctuating hormones. But hormones aside, your life is about to change in a big way — and who wouldn't feel emotional about that?

Spotting (spots of blood on your underpants or toilet tissue after urinating) or bleeding is relatively common in early pregnancy, affecting up to a quarter of pregnant women. It may occur in a normal pregnancy, but sometimes it can be the first sign of miscarriage or an ectopic pregnancy. If you have any spotting or bleeding, call your provider
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Your pregnancy: 5 weeks

How your baby's growing:


Deep in your uterus your embryo is growing at a furious pace. At this point, he's about the size of a sesame seed, and he looks more like a tiny tadpole than a human. He's now made up of three layers — the ectoderm, the mesoderm, and the endoderm — which will later form all of his organs and tissues.

The neural tube — from which your baby's brain, spinal cord, nerves, and backbone will sprout — is starting to develop in the top layer, called the ectoderm. This layer will also give rise to his skin, hair, nails, mammary and sweat glands, and tooth enamel.

His heart and circulatory system begin to form in the middle layer, or mesoderm. (This week, in fact, his tiny heart begins to divide into chambers and beat and pump blood.) The mesoderm will also form your baby's muscles, cartilage, bone, and subcutaneous (under skin) tissue.

The third layer, or endoderm, will house his lungs, intestines, and rudimentary urinary system, as well as his thyroid, liver, and pancreas. In the meantime, the primitive placenta and umbilical cord, which deliver nourishment and oxygen to your baby, are already on the job.

How your life's changing:


Pregnancy Due Date Calculator

You may notice some pregnancy-related discomforts already. Many women report sore breasts, fatigue, and frequent urination starting in the early weeks. You may also have nausea, though it's more likely to show up in the coming weeks.

The outside world won't see any sign of the dramatic developments taking place inside you — except that you're turning down that glass of wine with dinner, perhaps. It's important to avoid alcohol throughout your pregnancy since no one knows exactly how much — or how little — alcohol can harm a developing baby.

You'll also want to continue or start an exercise routine. Exercise helps you develop the strength and endurance you'll need to manage the extra weight you'll be carrying. It may help prevent some of the aches and pains of pregnancy, and many women find that it's a great stress-reducer. Exercise can also help you get ready for the physical rigors of labor.

Finally, it's easier to bounce back after you give birth if you've continued some form of exercise throughout pregnancy. Choose a safe, moderately vigorous activity you enjoy. Walking and swimming are fine choices for pregnant women
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Your pregnancy: 4 weeks

How your baby's growing:


This week marks the beginning of the embryonic period. From now until 10 weeks, all of your baby's organs will begin to develop and some will even begin to function. As a result, this is the time when she'll be most vulnerable to anything that might interfere with her development.

Right now your baby is an embryo the size of a poppy seed, consisting of two layers: the epiblast and the hypoblast, from which all of her organs and body parts will develop.

The primitive placenta is also made up of two layers at this point. Its cells are tunneling into the lining of your uterus, creating spaces for your blood to flow so that the developed placenta will be able to provide nutrients and oxygen to your growing baby when it starts to function at the end of this week.

Also present now are the amniotic sac, which will house your baby; the amniotic fluid, which will cushion her as she grows; and the yolk sac, which produces your baby's red blood cells and helps deliver nutrients to her until the placenta has developed and is ready to take over this duty.

See what's going on in your uterus 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:

Sometime this week, you may be able to find out whether you're pregnant. For the most accurate results, wait until the end of the week to take a home pregnancy test. (You can try one now if you like, but you're more likely to get a correct result a week past your expected period.)

If the test is positive, call your practitioner's office and schedule your first prenatal appointment. Most practitioners won't see you until you're about eight weeks along, unless you have a medical condition, had problems with a previous pregnancy, or are having symptoms that need to be checked out.

If you're taking any medications — prescription or over-the-counter — ask now whether it's safe to keep taking them. And be sure to alert your caregiver to any other issues of concern.

You should already be taking a multivitamin that contains at least 400 micrograms (mcg) of folic acid. Once you're pregnant, you'll need a bit more — 600 mcg a day — so switch to a prenatal vitamin if you haven't already.

The next six weeks are critical to your baby's development. The rudimentary versions of the placenta and umbilical cord, which deliver nourishment and oxygen to your baby, are already functioning. Through the placenta, your baby is exposed to what you take into your body, so make sure it's good for both of you.

If your home pregnancy test is negative, take another at five weeks if you still haven't gotten your period. Many urine tests are not sensitive enough to detect a pregnancy at four weeks.

If you've been trying to conceive with no success for a year or more (or for six months if you're over 35), talk to your healthcare provider about a workup exam for you and your partner to spot possible fertility problems. While the results may be upsetting, finding out about a problem sooner rather than later will get you started on the road to treatment — and to your ultimate goal: having a baby.

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Your pregnancy: 3 weeks

How your baby's growing:


What's going on in your womb now? A lot. Your baby-in-the-making is just a tiny ball consisting of several hundred cells that are multiplying madly. Once the ball of cells (called a blastocyst) takes up residence in your uterus, the part of it that will develop into the placenta starts producing the pregnancy hormone hCG (human chorionic gonadotropin), which tells your ovaries to stop releasing eggs and triggers increased production of estrogen and progesterone (which keep your uterus from shedding its lining — and its tiny passenger — and stimulates placental growth). HCG is the hormone that turns a pregnancy test positive; by the end of this week, you may be able to take one and get a positive result! (If your test is negative and you still haven't gotten your period in two or three days, try again then.)

Have you told others you're trying?

Meanwhile, amniotic fluid is beginning to collect around your ball of cells in the cavity that will become the amniotic sac. This fluid will cushion your baby in the weeks and months ahead. Right now, your little blastocyst is receiving oxygen and nutrients (and discarding waste products) through a primitive circulation system made up of microscopic tunnels that connect your developing baby to the blood vessels in your uterine wall. The placenta won't be developed enough to take over this task until the end of next week.

How your life's changing:


A momentous meeting has taken place inside you — a single sperm has broken through the tough outer membrane of your egg and fertilized it. Several days after conception, the fertilized egg burrowed into the lining of your uterus and started to grow. A baby is in the making! You probably don't know you're pregnant yet, but you may notice a little spotting by the end of this week. This so-called "implantation spotting" may be caused by the egg burrowing into the blood-rich uterine lining (a process that began last week at 6 days after fertilization), but no one knows for sure. In any case, the spotting is very light and only a minority of pregnant women experience it at all.


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Your pregnancy: 2 weeks

How your baby will grow


Before she actually starts growing, you'll set the stage. Last week an increase in the amount of estrogen and progesterone coursing through your bloodstream prompted your uterus to form a lush, blood-rich lining of tissue to support a potential fertilized egg. At the same time, in your ovaries, eggs were ripening in fluid-filled sacs called follicles. At the beginning of this week (often around day 14 of a 28-day cycle), you ovulate: One of your eggs erupts from its follicle and is swept away from your ovary and into a Fallopian tube. During the next 12 to 24 hours that egg will be fertilized if one of the 250 million sperm (on average) your mate ejaculates manages to swim all the way from your vagina through your cervix, up into your uterus to the Fallopian tube and penetrates the egg. Only about 400 sperm will survive the arduous ten-hour journey to the egg, and only one will succeed in burrowing through its outer membrane. (It takes about 20 minutes for the lucky winner to find his way in.)

Over the next ten to 30 hours, the sperm's nucleus will merge with the egg's as they combine their genetic material. If the sperm carries a Y chromosome, your baby will be a boy; if it's an X chromosome, you'll be welcoming a girl. During the three- to four-day trip from your Fallopian tube to your uterus, the fertilized egg (now called a zygote) will divide into 16 identical cells. Once it enters the uterus, the zygote is called a morula. A day or two later, it will begin burrowing into the lush lining of your uterus, continuing its amazing growth and transformation. By this time your developing baby is just a little ball of cells that's officially referred to by scientists as a blastocyst: It has an inner cell mass that will become the embryo itself, a fluid-filled cavity that will become the amniotic sac, and an outer cell mass that will become the placenta, the pancake-shaped organ that delivers life-sustaining oxygen and nutrients to your baby and carries away her waste products.

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

Quick Clicks

Getting pregnant: How babies are made

Folic acid in your pregnancy diet

Sexual positions for baby-making

Are your monitoring your cycle or just trying your luck?

Your last period started 12 to 16 days ago, so you're probably ovulating now or will be soon. Strange as it may seem, your practitioner calculates your due date (and your baby's gestational age) starting from the first day of your last menstrual period. Pregnancy lasts about 38 weeks from conception, but since it's often difficult to pinpoint exactly when egg and sperm merged, doctors and midwives simply count 40 weeks of pregnancy beginning with the onset of your last period. That's why you're already considered to be two weeks into your pregnancy when fertilization occurs.

A lot of things have to fall into place for conception to happen — in this case, timing really is everything. To boost your odds, aim to have sex sometime between 72 hours before you ovulate and 24 hours after. (You're trying to accommodate the lifespan of both sperm, which survive for up to 72 hours, and the egg, which lives no more than 24 hours after ovulation.) Now's not the time to hesitate: Make sure your mate clears his calendar and that the two of you have plenty of time together to make love.

Before you retreat to the bedroom, though, you might want to do some homework: Read up on detecting ovulation to help you pinpoint your window of opportunity. Get the scoop on which sexual positions may help you conceive faster and even how you might influence your baby's gender. Finally, to spare you and your partner unneeded anxiety, learn how long it usually takes to get pregnant — most couples need more than a few tries before they can announce that a baby's on the way.

Last but not least, if you're trying to get pregnant and you haven't already stopped drinking, smoking, and taking drugs — even over-the-counter ones — now's the time to do so, since you want your body to be in the best possible shape for baby making. (If you're taking any prescription drugs, check in with your health provider to find out whether you should continue taking them.) And don't forget to take a daily multivitamin that contains at least 400 micrograms of folic acid (ideally starting three months before you want to conceive) to reduce your baby's risk of birth defects.

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9 Tips for Parenting in the 90s

Getting your infant off to a healthy and secure start:


Breastfeed. There's no doubt about it, your baby deserves breastmilk. Breastfeeding your baby from birth develops a strong maternal attachment, gives your baby all the nutrients he or she needs, plus delivers many infection fighting agents, hormones, and more.

Wear your baby. Research has shown that babies that are carried for most of the day cry up to 50% less than babies who are not. Wearing your baby makes frequent breastfeeding easier, and frees up mom's hands for other duties. 9 months in the womb, 9 months in arms is a good rule of thumb.

Consider a natural childbirth. Most women who have given birth naturally describe their birth as empowering. Research the kind of birth that you want, and work with your healthcare provider in order to get it. A good childbirth experience can help prevent postpartum depression and make the transition to motherhood a little bit easier.

Have Dad stay home, too, at first. Having the father or other support person home with mom and the baby in the initial weeks really promotes family bonding and a greater understanding of the difficulties of life with an infant for the father. Plus, mom is less overwhelmed.

Consider staying home & if you work, keep nursing. Baby's first year is critical to his or her development, and many mothers find when the time comes to return to their jobs, they'd prefer to stay home. Take a look at your finances and be open to the possibilities. If you do work, you'll be surprised at how good it feels to continue the bond of nursing despite the time away from your infant. Consider pumping your milk for your baby as well. Many mothers do not resent the time it takes to pump (5-20 minutes), knowing that they're doing something for their baby that no other can. Check out The Working Cow for more information on combining working and nursing.

Share sleep with your baby. Also called cosleeping and the family bed, sharing sleep is great for giving moms and dads a good night's sleep, along with their baby. For millennia sharing sleep has been the human norm, and only recently has separate bedrooms been practical. Sharing sleep can make nighttime parenting a breeze (and a joy in the morning!)

Delay solids. At the turn of the century, doctors recommended no solids for the first year. 20 years ago, many recommended solids from birth. According to the WHO, solids should not be introduced until after 6 months, and then only in addition to breastmilk.

Pay attention to your baby's cues. No education programs are necessary, and it isn't necessary to flash cards at your infant or otherwise try to increase his or hers intelligence. Simply watch your baby and take turns leading each other into play.

Take your own advice. No one knows your baby like you do. Listen to the baby experts if you want to, but remember, YOU are your own baby expert.



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