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Hi Tori,
Yesterday I saw the specialist and they could find no sign of a uterine septum. He came to the conclusion, that when they did my ultrasound at my Doctor’s office, I was likely having a uterine contraction which can look like a dark mass on an ultrasound. You were right, it would not have just appeared, it would have always been there. Thank God! In my case everything was completely normal. Our baby girl is growing great and looks wonderful.Thank You Tori for everything!
Sincerely, Elaine
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No Margo, you shouldn’t be worried at all. It is not uncommon to not see much movement at this gestational age. There are so many variations of what is normal. Your ultrasound was perfectly normal for this time and a later ultrasound is likely to show you much more movement. You may even feel the baby moving before your next ultrasound. Congratulations!
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Hi Tori, I am 41 yrs. old and my husband and I have 5 beautiful boys. We are pregnant with our 6th, and found out today it is a girl. The entire family is excited beyond words.
My doctor just called me to refer me to a ultrasound specialist, because he said they seen an uterine septum in the ultrasound today, and because of my age he wants to make sure everything is fine. I am scared! What is a uterine septum and is it something I should be concerned about?
Sincerely, Elaine
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Hi Elaine — Congratulations on adding a baby girl to your family!
A uterine septum is a band of tissue in the middle of the uterus, usually without much of a blood supply that results from a congenital problem in the formation of the woman’s uterus.
There are several different types of septums and it can be a reason for recurrent miscarriages. The fact that you have 5 healthy children and, I assume previous uncomplicated pregnancies, it appears very likely that yours is not problematic. It has always been present but it appears that this was the first time it was noted on ultrasound.
Please let me know how things continue to move along in your pregnancy.
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Hi Tori, I am 31 weeks pregnant and since about 28 weeks I have noticed that the lips of my vagina are very swollen and irritated. This is my 3rd pregnancy and my daughter is very low compared to my other two. Also, the inside of my vagina is irritated and red and I have some burning and itching. Please help me, because I want to know what I am going through.
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Hi Lydia,
I’m sorry you are so uncomfortable. A couple of things could be going on. You could have some vulvar varicosities (enlarged blood vessels) which can cause swelling and pain or pressure on the lips of your vagina. However, the burning and itchy sounds more like a yeast infection or some kind of irritation. I think it would be best to have a visit with your practitioner. They may prescribe some kind of medication or creme for the irritation. Please let me know what you find out.
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Tori,
Thank you for the information you provided. It makes me feel so much better to know that there was nothing that I did to cause preterm labor…I am and will try my best to get through this and will definitely see a perinatologist in a future pregnancy….again thank you and I will continue to seek your advice.
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Hi Tori,
3 weeks ago I lost my baby girl at 22 weeks gestation. I went into preterm labot yet I didn’t have any symptoms to warn me… I simply started getting one contraction after another and by the time I got to the hostpital my bag of water was already ready to rupture and there was nothing the doctors could do for us.
I had an ultrasound and I could see her moving and she still had a heartbeat but when I gave birth to her (vaginally – even though the nurse said I had a marginal placenta previa) the doctor said she was born dead.
My questions are:
*could my marginal placenta previa caused her death even though i had no warnings like bleeding etc.?
*could it have been that I got pregnant too soon (2 months after having my 1st baby)?
* is it because I would carry my 6 month old even though i was pregnant?
ps: the doctor suggested an autopsy since the baby looked normal physically..but I was so out of it and couldn’t bear the image of my baby being cut open that i said no… now I regret not having the autopsy.
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Dear Carla,
I am so very, very sorry about your loss of your daughter. I want to assure you, immediately, that nothing you did was responsible for your miscarriage. Becoming pregnant soon after your first baby and carrying your older child absolutely does not (and did not in your situation) cause preterm labor. You experienced true preterm labor. Often it comes quickly and without much pain or warning. Very little is understood about what actually does cause it and how to prevent it in all situations.
In the highest level intensive care nursery (NICU), a baby still has minimal chances of surviving and being healthy when born at 24-25 weeks. It is simply not possible for a baby to survive earlier than that. Although you may have had a marginal placenta previa, it does not seem to be a factor in this. I do not know the entire circumstances of your baby’s birth but from my previous experience with this, it is most likely that she died because she was too early to be born.
When an autopsy is performed on a premature baby, the vast majority of the time, the baby is found to have been perfectly healthy. Please do not regret your decision to have not had an autopsy. It is a very difficult time to make those kinds of choices.
You need emotional and physical time and support to heal from your loss. It is important to express all your feelings of sadness and grief and to not rush the process. When you feel ready to consider becoming pregnant again, it will be very important that you see a Perinatologist. This is a specialized, high risk obstetrician who should care for you in your next pregnancy.
Please know my thoughts and prayers are with you and please contact me anytime if you have any questions or need support.
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Hi Kelsey ,
No, there is no correlation between a mom using pain medication for labor and her child’s reaction to pain. Although a small amount of pain medication does cross the placenta, it does not impact the baby in a negative way. Pain medications that are used for labor and birth today are safe for both mom and baby. The choice to have pain relief should be based on how the mother feels she is coping.
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Hi Tori,
I am 32 weeks pregnant and I went to the L&D ER because I was contracting every three minutes. I have a complete previa and, via ultrasound, just found out the baby is breech. I recieved two shots of Terbutaline and took my own oral Terbutaline to stop the contractions. The contractions did slow down alot but I still felt them and they sent me home. Is this normal practice? They also gave me two Percocet prior to leaving and I drove myself to the ER. Isn’t driving myself home after taking Percocet dangerous?-
Hi Gabriela,
I am sorry that you had a stop in the hospital. Yikes! I cannot even imagine how you drove home after the two shots of Terbutaline! Most women become very jittery after just one shot.
It sounds as though you were having a run of contractions, which is not at all abnormal for 32 weeks. However, since you have a complete previa, any kind of contractions can trigger an episode of bleeding for you. My guess is this is why you were treated with two doses of Terbutaline.
Percocet, although an excellent pain reliever, would not be my choice for this situation. If you were having pain, the pain likely stopped when the contractions stopped, which is what the Terbutaline did.
I agree with you that you should not have driven yourself home after taking Percocet. If you ever do need to go to the hospital again for contractions, please try to have someone go with you in case you are given medications while you are there.
A good thing to know is that, if ever you are having contractions, first have two full glasses of water and wait 30 minutes. Frequently, just a bit of hydration stops them.
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My husband and I are Americans living in Portugal, and we have just started a Lamaze class. From the first two classes, it seems like the instructor may not know her stuff. For example, she says that under no circumstances should a woman gain more than 20 lbs. during pregnancy. Milk, nuts and dried fruit should be avoided, and all fruits and vegetables must be cooked before eating. She also taught us a pelvic tilt exercise incorrectly. Should we drop the class and watch a DVD course instead? This is the only class in English around.
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Thanks for writing Heather,
I agree that the instructor does not know her stuff. What she seems to be telling you doesn’t even make any sense. I would not continue the course if I were you. I cannot imagine that the childbirth information she would give you would be either current or necessarily useful.
I am hoping that you have a copy of The Joy of Pregnancy. If you don’t, please download it free from our homepage. The chapters on labor and birth are thorough, illustrated and detailed. Honestly, if you think that you and your husband want to see more actual birth videos there are tons on youtube. I would just do a search and see what comes up.
Do you have a nurse-midwife or doctor that can recommend any other options for you?
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Sunita,
At this gestational age, having a “low-lying placenta covering the os” means that your placenta is completely covering the opening of the cervix. The fact that your cervix is 4 cm. long (as opposed to dilated) and closed is exactly how it should be.
Very often, as the uterus enlarges, the placenta moves away from the opening of the cervix, however, at this early stage you still can’t be certain it will. This means that you may have a complete or partial placenta previa.
This potentially puts you and risk for bleeding problems during your pregnancy. I would not recommend traveling unless you have had another ultrasound which shows that the placenta is now completely away from the os (opening of the cervix). Please talk more with your doctor about this.
I wish you the best and please let me know how things move along.
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Tracy,
Your son has something called a “nevus” or a birth mark. “Strawberry nevus” or “stork bites” are pinkish/red pigment areas commonly occurring on the head or neck area. This is a condition which occurs mostly in fair skinned babies. They are not harmful and generally are hidden in the hairline. Often they fade as the child grows older.
Darker skinned children can also have a type of pigment “nevus” known as “mongolian spots”. These are darker skin pigment areas which most commonly are seen on the low back or buttocks area. They are also not harmful.
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Dear Tori,
Everything I read which addresses postpartum depression says that you should seek professional help. Is there anything else a mother can do besides act like a “psycho”? I’m not sure if this is my problem, but I have no way of finding out or discussing it with anyone, unless I spend $100/hr or more. Help!
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Please take a look at my Postpartum Depression Video
Feeling blue, overwhelmed, crying often, and not being sure whether being a mom is the right thing for you is very, very normal for a new mom (or dad). Sleepless nights, the joys and challenges of a new baby, and your own hormonal changes can make any completely normal woman feel like a “psycho”. Finding and connecting with other new parents can be a tremendous help. Oftentimes local hospitals or community centers have new moms (or new parents) support groups. If you attended childbirth preparation classes, your instructor may have some suggestions. These are generally free. In my experience talking to someone about how you feel is the most helpful thing you can do for yourself.
If you feel so blue or depressed that you cannot get out of bed in the morning or really are unable to care for yourself or your child, it is more important than anything is you may ever do, to actually seek professional help. For starters, call your doctor or midwife and tell them honestly how you are feeling. If you truly are feeling frightened or overwhelmed it is important to not minimize these feelings to those who can help you. Many professionals offer “sliding” fees, which can offset the costs. There also are public resources at little or no cost.
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I had twin girls four years ago. I was told they were in separate sacks and therefore, not identical. Once they were born, the doctor said they might be identical because they have the same blood type. Is there any way to know for sure if they are identical or fraternal? Please help, I get asked all the time if they are identical and don’t know what to answer.
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Thanks for your question. The fact that twins are identical or fraternal is not determined by whether or not they share the same amniotic sac. Identical twins occur when one egg divides into two, resulting in the babies have the same, identical genetic makeup. Fraternal twins occur when two separate eggs are fertilized.
In utero, 90% of “identical” twins actually have two separate amniotic sacs. It is extremely rare and quite dangerous for identical twins to share one sac. There is a high risk of the two babies’ umbilical cords entangling at some point during the pregnancy.
Your girls could indeed be identical twins, especially if they look a great deal alike. That they share the same blood type isn’t an indication either, as it is quite common for siblings within any family to have the same blood type. The only way to know for certain is to have them genetically tested. Your pediatrician will be able to help you learn how to do that and the costs involved.
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Many, many women have had small or moderate amounts of alcohol, taken medicines and have had a multitude of experiences prior to discovering that they were pregnant. Certainly we know that alcohol abuse during pregnancy can be harmful to a growing baby and can cause what is known as “fetal alcohol syndrome”. Unless your alcohol consumption was excessive, your baby is extremely likely to be completely healthy. I understand how hard it is not to worry but it is not good for either you or your baby. Reassure yourself by talking with your practitioner and most importantly, now that you are pregnant, stay away from alcohol and drugs and enjoy your pregnancy. It is such a special time.
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Sally –
Yes, it is very normal to have periods of dizziness and or feelings of faintness, during pregnancy, especially during the early weeks. Your blood pressure tends to be lower during pregnancy and this is the cause of the faintness you are experiencing. It is important not to stand for long stretches of time or to get up too quickly after you have been sitting or lying down. This moves blood away from your brain, which results in your feeling lightheaded. Two great habits to adopt are; 1.) to roll onto your side before rising out of bed, 2.) when standing for periods of time, bend your knees often. This helps to keep your blood circulating well.If you are feeling dizzy or lightheaded, it is best to sit down and put your head between your knees. This helps blood to move up into your head, making you feel better. The good news is that this usually passes in the second trimester.
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Hi Tori,
A friend gave me your book and I am really enjoying reading it. I also love your blog.
I am 8 weeks pregnant and since I have been hearing so much in the news these days about breast cancer, I really want to be sure that I take care of myself. I am a little confused about whether or not I should do them even though I am pregnant. I see a doctor at a clinic and I am not really comfortable asking these detailed questions of my doctor. I am also not sure if I am doing it right–is there a certain way to do it? Please help!
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Congratulations and I am so happy to have you here!
Good for you that you are taking the initiative to take care of your body and your health. The answer to your question about whether or not you should be examining your breasts, even though you are pregnant is yes, yes, yes. It is also very important to feel comfortable enough with your practitioner to ask all your questions, understand your care and have your questions answered. You may want to see if your clinic has a nurse practitioner that you may feel more comfortable talking with.
When you are not pregnant, the best time to perform a self-breast exam is after your period is over when your breasts are less likely to be tender or lumpy. During pregnancy, you can simply choose a day of the month as your “breast check day”. It is rare but possible to develop breast cancer and/or for the hormones of pregnancy to accelerate cancer during pregnancy. Therefore, it is very important to continue with your breast health activities throughout your entire pregnancy.
There is no special or magic way to examine your breasts. The important thing is to get a good sense of what your own body feels like. Then you will know if something feels different or has visually changed. Many women examine their breasts while standing in the shower, although you could also sit or lie down.
You should first look at your breast in a mirror, both with your hands at your side and then behind your head. Look for any dimples or abnormalities in shape. Next, you will want to feel your breasts in either a circular motion or in an up and down motion for any lumps. Squeeze the nipples of each breast slightly to check for any discharge. Once you do this a couple of times, you will feel more familiar with your own breasts. Be sure to let your doctor know of any lump or suspicious area that you find. It may be perfectly normal but is best to have checked out.
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What Is An Sonogram?
Sonograms, also called ultrasounds, refer to high frequency sound waves. When these sound waves hit a dense mass, tissue or fluid, they produce echoes, which bounce back to a receiver. The receiver then translates these into a signal that converts to either sound (fetal heartbeat) or an image.
Ultrasound technology is used during pregnancy for the familiar fetal “scan”, to listen to the baby’s heartbeat (Doppler) and for electronic fetal monitoring during labor.
The most common reasons it is used are:
Confirming a pregnancy and checking for twins or more
Estimating gestational age
Checking fetal growth
Checking the well being of the baby – including blood flow to and from the placenta, as well as how much amniotic fluid is around the baby.
Diagnosing a miscarriage, bleeding and fetal or placental abnormalities.
Confirming the position of the baby for procedures such as an amniocentesis or turning the baby from a breech position to head down (external cephalic version).Are They Safe?
It has been over 40 years since ultrasound was first used on pregnant women. Although some harmful effects in cells have been observed in a laboratory setting, abnormalities in embryos and the offspring of animals and humans have not been demonstrated.Apparent ill effects such as low birth weight, speech and hearing problems, brain damage and non-right-handedness reported in small studies have not been confirmed or substantiated in larger studies from Europe. The studies were not adequately performed or large enough to show actual validity.
Of course, it remains important for scientists to continue to study the effects of this technology. Ultrasounds are considered to be a very safe method of providing valuable information during pregnancy. There is no indication that they are harmful or affect the baby in any way.
In some areas, women can even choose to see their babies in 3-D or 4-D color scans. Sometimes these sonograms are offered in non-medical settings that are set up very much like photography studios. Personally and professionally, I have mixed feelings about having an ultrasound merely for a photo or video of the baby. I think it is sensible to have one only as needed, and recommended by your care provider.
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Omega-3 fatty acids, docosahexaenoic acid (DHA) and eicosapentaenoic acid (EPA), are essential nutrients for optimal fetal and infant neurodevelopment. A recent study has shown that deficiencies of these in pregnancy increase the baby’s risk of developmental delays in communication, fine motor, and social skills. The richest sources of omega-3 fatty acids are oily fish. However, many fish rich in these fatty acids also contain dangerous pollutants such as mercury, a neurotoxin. There is much controversy over how much fish women can safely eat during pregnancy without exposing their babies to too much neurotoxin. Omega-3 fatty acids are found in pumpkin and flax seeds, but in much lower levels than in oily fish. High-quality omega-3 supplements may be a good alternative. Discuss these with you practitioner.
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You are not alone! A man’s discovery that he is going to be a father brings up many emotions. In addition to being happy, you have new concerns. You may be worried about the health and safety of your wife and baby, the responsibilities of parenthood, household finances, changes in your lifestyle, and much more. Things that you have never worried about before may suddenly seem like looming problems. The enormous scope of fatherhood is often underestimated. Many men experience physical symptoms of anxiety as they adjust to their new role. The good news is that your anxiety will very likely pass. In the meantime, share your feelings with your wife or a close friend. If you find that you are continuing to worry, talk with your doctor about how you feel.
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Blue cohosh, or Caulophyllum thalictroides, is also sometimes called blueberry root, papoose root, squawroot, yellow ginseng, blue ginseng, or beech drops. Harvested in wooded areas of eastern North America, the root was originally used by Native Americans as a uterine stimulant. It is used in various forms to induce labor contractions. In my experience, blue cohosh can indeed cause uterine contractions, but it does not necessarily initiate labor. It can also have the unpleasant side effects of diarrhea, nausea, vomiting, and abdominal cramping.
Like other medicines, herbal remedies can be very powerful. It is very important to talk with your midwife or doctor before taking any medicinal herb.
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My doctor’s nurse phoned this week to ask if I knew that my blood type was Rh-negative. I had been told this years ago but had forgotten about it. The nurse said that if my husband is also Rh-negative (we will find out this week), I have nothing to worry about. If he is not, I have to receive a shot at 28 weeks. Can you please explain why this is necessary?
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Mary,
Rh factor, or Rh antigen, is a substance present by heredity in the blood of most people. Only 15 percent of us lack Rh factor, or have Rh-negative blood. Years ago, babies often died from what was known as Rh incompatibility, or rhesus disease. Today, we can prevent this from happening. If both you and your husband have Rh-negative blood, then the baby will also have this blood type, and no treatment is needed. If, however, your blood is Rh-negative and your husband’s is Rh-positive, the baby may have Rh-positive blood. In this case, your body could begin producing antibodies to your baby’s red blood cells. If you have never been pregnant before, your baby would be unaffected by these antibodies. They would remain dormant and harmless unless you became pregnant again. Then, if your baby were Rh-positive, the antibodies could cross the placenta and attack the baby’s red blood cells. This could cause anemia and mild to severe jaundice in the baby. To prevent this problem, an Rh-negative mother with an Rh-positive partner receives a shot of Rh immune globulin, or RhoGAM, at 28 weeks of pregnancy and again within 72 hours of giving birth. Rh immune globulin is also given to an Rh-negative woman after a miscarriage, an ectopic pregnancy, or an induced abortion, and at the time of amniocentesis, CVS, or another invasive procedure during pregnancy. A shot of RhoGAM should be considered, too, if an Rh-negative woman experiences any significant bleeding or blunt trauma, such as from a car accident or fall, while she is pregnant. This kind of injury can also cause Rh sensitization.
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A genetic counselor is a specially trained health professional who works with a couple to determine their risk of passing on an inheritable disease to their baby. The counselor thoroughly investigates the personal and family health history and ancestry of both mother and father. He or she helps the couple interpret information about a particular disorder, learn about inheritance patterns and the risks that a disease will recur, and review available options.
Genetic counseling is unnecessary for most couples, but it can be very helpful if you fall into one or more risk categories.
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Hi Tori -
I’m 21 wks pregnant and my doctor called me to tell me that my last ultrasound shows that i have placenta previa. He told me that I need to limit my activities and have no intercourse. Does this mean I have to be on bed rest? Does this mean that I cannot have any stimulation at all with my husband? Can I take bubble baths?
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Hi Lina — Placenta previa occurs when the placenta lies in the lower portion of the uterus, covering or partly covering the cervix. The danger is that when the cervix begins to dilate, the placenta could separate from the uterine wall. The separation could lead to hemorrhage (extremely heavy bleeding) and a reduction in the baby’s blood and oxygen supply.
To prevent possible further bleeding, it is important to limit your activities or to remain on bed rest. It sounds as though your doctor has not placed you on full bedrest at this time but rather has said that you need to slow down your activities, stop working and minimize the possibility of bleeding. If you have an episode of bleeding, it is likely that he will have you go to complete bedrest.
DIfficult as it is, it is important not to have intercourse or place anything inside your vagina. Unfortunately, it also means no orgasms for you as orgasm can cause uterine contractions which in turn can cause bleeding. Taking a bubble bath or a bath of any kind is fine.
Hang in there. Please let me know if other questions come up for you.
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Hi Tori – I am 38 weeks and 4 days pregnant with my second daughter. Is there anything i can do to prepare my cervix more for delivery and/or initiate labor because i’m at the point where i can’t sleep anymore. I have a 15 month old daughter to chase around, and I would like to just have my baby on the outside rather than inside! My doula said primrose oil, and told me to take 1,000mg orally and then insert 1,000mg into my vagina at nght to help soften my cervix and ripen it. I’ve tried castor oil, though it’s been around 10 days since i’ve tried that. Should i try it again? Did i try too early? My baby is dropped, I’m 80% effaced and 2.5-3 cm dialated…my body just needs a PUSH to get going. HELP PLEASE!!!!
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Ah– I feel for you, Brianna. The last weeks of pregnancy can be very challenging. I think in many ways preparing you to “want” labor due to the discomfort of those last moments of pregnancy.
I wish that I had a magic answer. Although primrose oil can soften the cervix it has no bearing on when you will go into labor. Since effacement is the softening of the cervix and your cervix is already 80% effaced, you need no more softening. I’m afraid castor oil is not the magic potion either. Since castor oil stimulates the bowel, if your body is ready to labor, it can get things going. The key is “if your body is ready” which it sounds like yours just isn’t. The real downside of castor oil is that it can really give you cramps and loose stools which is just more unpleasant.
Sex sometimes gets things going due to the prostaglandins in semen but again, only “if your body is ready”. The best possibility is for your practitioner to “strip your membranes” which means that he or she performs a vaginal exam and slightly separates your amniotic sac from the uterine wall. Again, this is an attempt but not a sure thing.
I suspect that your baby just isn’t ready to be born yet. She just may need a little more growing time. If you can, I encourage you to let nature take it’s course, hard as that is. Please let me know when you give birth and how things go. I wish you all the best.
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Hi.. So this is embarrassing, but really kind of worrying me! So I am almost 26 weeks pregnant with my 2nd child and for the past 2-3 weeks I have been itchy with quite a bit of pain and discomfort on the outer part of my vagina.. When I am sitting, squatting, or going to the restroom I also feel a lot of pressure, like the baby is forcing her way out!! I called my doctors office and they told me to try an over the counter medication for yeast infection, but I have gotten no relief!!! Is this something that can be normal in pregnancy or should I be worrying as much as I am??? Thanks!
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Fifth disease is caused by a parvovirus B19. The reason is has it’s name is that it is the fifth in a group of six childhood diseases that cause rash and fever. The symptoms of rash and fever are generally mild and frequently go unnoticed. The virus is also known as “slap cheek” due to reddened cheeks that can occur with the rash.
Although it is uncommon to develop fifth disease during pregnancy, a pregnant woman should try to stay clear of anyone who is known to have it. Most women are in fact immune, having been infected as children without having been aware of it.
If a woman is not immune and does contract the virus (such as with your sister) there is a very rare (less than 10%) increased risk of an early miscarriage or a rare form of fetal anemia. It is best that your sister follow her practitioner’s advice in this situation, however, she and her baby are very likely to be unaffected.
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A major blood vessel known as the inferior vena cava runs up your back from your legs. It is responsible for returning blood to your heart. As your uterus and your belly grow, there is increased pressure on this vessel when you are lying flat on your back. You know that you’ve been in this position too long if you have the sensation that your legs are falling asleep or you just feel uncomfortable. As your pregnancy progresses, you will probably be more comfortable lying on your side. This position allows maximum blood flow through your body and to your placenta and baby.
We all move around a great deal while we are sleeping. Please don’t worry if you wake up on your back; this is perfectly normal. Just reposition yourself so that you are comfortable.
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Different women begin to show at different times. When you will start to show depends on your overall body size, your height, your pre-pregnancy weight, and, especially, the length of your midbody. Women with longer midbodies tend to hide their babies longer and look smaller than do other women whose babies are at the same gestational age. Women who have already given birth, as your sister has, tend to show a little earlier in a subsequent pregnancy. How the baby is positioned in the uterus also partly determines how the mother’s body looks.
Most women have at least a little bump by 15 weeks. At first, though, you and your partner may be the only ones to notice your bump. Often, other people don’t recognize that a woman is pregnant until she is about 20 weeks along. Although I am petite, when I was pregnant with Alexander, I did not develop even a bump until 16 weeks. I wore maternity clothes because I was excited, but I really didn’t need them until I was six months along. Try not to be concerned about comments such as “Oh, you look so small!” (People may be asking your sister, “Wow! Is that just one baby in there?”) No one can tell, just by looking at you, what size your baby is.
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Hi Tori! I had a m/c in 9/7/09. I was 11 wks and 4 days pregnant. My question is: is lifting heavy patients (in nsg home) ranging 100 lbs- 300lbs could possibly be the cause of my m/c? I had a previous m/c 2 1/2 yrs ago. I asked my OB if i have any limitation at work now that i am pregnant again and she said none. I didnt have any prob during my pregnancy…no d/c or anything…except when i strain to assist bariatric patients to stand…i would leak little amt of fluid..i know its not urine…it was clear, no odor. didnt pay attn to it until fri 9/6/09 when we assisted a 300lb lady to stand..i leaked more than usual..still not enough to saturate my undies, however, i felt minimal cramping and it lasted overnight. come morning i saw bld when i urinated. then it would stop and then more bld came out when i tried to do anything in standing so i decided to lie down and propped my feet up. After awhile, i felt like i peed and fluid gushed out (saturated my undies) then blood and more blood..with cramps…that got severe as time goes by. went to ER and had a m/c again.
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Hi Maria, I am so sorry that you had a miscarriage in September. Please let me reassure you that absolutely nothing you did caused it to happen. I am so often asked this and it is a completely natural question to wonder.
It is possible that your amniotic sac had a slight tear in it for a time before you miscarried but it was due to there being a problem with the pregnancy itself, not the fact that you lift patients in your work. Our bodies are designed to handle the physical work we do, even during pregnancy. Such things as physical activities, lifting, even emotional upset, do not cause a miscarriage. Often, if a woman has two successive miscarriages her doctor may suggest some additional testing to be sure that there is not a hormonal or physiological cause. You may want to ask your doctor if she thinks you should have any additional testing done.
I wish you all the best in growing your family.
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Josie,
It does sound as though it certainly could be your mucous plug passing. You are about 5 weeks early so you should alert your care provider right away. He or she will ask you if you have been feeling any contractions or cramping and will very likely want to see you.
37 weeks (or 3 weeks before your due date) is really the earliest we like babies to be born. Prior to that their lung development may not be complete and they have not completed their growing. This can result in a longer hospital stay for the baby and some prematurity problems. Please let me know how things are going.
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Nan, I am so sorry you are experiencing the discomfort of PUPPP. PUPPP stands for pruritic urticarial papules and plaques of pregnancy and most commonly occurs in abdominal stretch marks but can also occur on the buttocks, thighs, and arms. As you know, PUPPP is itchy, itchy, and itchier. Its cause is unknown, but PUPPP is not a serious condition; it poses no danger to you or your baby. It lasts about six weeks, on average, and disappears within two weeks after birth. It generally doesn’t recur, even in subsequent pregnancies.
To lessen the itching, you can try taking oatmeal baths or use an over-the-counter anti-itch cream containing 1 percent hydrocortisone. If this doesn’t help, your doctor or midwife may suggest an antihistamine or, if the itching is very severe, a corticosteroid.
Yes, you should absolutely receive the H1N1 (swine flu) vaccine? Please read more information about this herein one of my recent blog posts. There is no contraindication in taking the vaccine with also having PUPPP. Please check with your practitioner about what they recommend.
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Hi Trisheena, I am so sorry that you feel as though you are being pulled in so many directions. I am not sure if you have other children or if this is your first baby but your body is working very hard in growing your baby. Pregnancy is a time to care for yourself as much as possible. It is important to get enough rest, to eat properly and to prepare for your new arrival.
This is the time to share with those around you the importance of this and to not overwork or over-stress yourself. I suspect you are pretty tired and asking for help may allow you to slow down enough not to feel as though you are taking on the world.
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I am 9 weeks according to my last period and I am starting to show already … I have 3 other children and am a little older with this one (36). I feel like I’m very bloated up high, just under my breast and it gets really hard sometimes and hurts. Is there something wrong ? I know I’m feeling very anxious about this pregnancy due to the fact that I am alot older than with the other 3. Is it just me being a worrier or should I be concerned about the odd way that I’m feeling ?
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Crystal, Thanks very much for your question. How you are feeling is very normal. With each baby that you have your uterus and skin become more relaxed and stretchier. This is what causes you to “show” earlier than you may have with your other children. Please know that there is no reason for you to be anxious about this pregnancy.
Although you are older than with your others, you are certainly quite young. I have no doubt that your life is very busy with three children. Please try to take good care of yourself; eat healthy foods and rest as you need to.
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I having a hard time deciding on whether or not to cont with my pregnacy. I am only about 6 1/2 weeks long. I’m about to be 33 years old and currently have no children. My partner is leaning more towards me not continueing but I am thinking I would like to be a mom. All the circumstances would say not have the baby: finacially, early into relationship w/ my partner, and just a bad ecomony in general. I feel very confused on my feeling about which choice I should make. Any advice…
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T Fort, Thank you for your question. Deciding whether or not to have children is such a personal choice, it is impossible for me to offer you advice. This is a very serious topic for you and your partner to work through. You may find Planned Parenthood to be a good source of more information. I wish you all the best.
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My husband and I are starting to try for our 2nd baby. We currently have a 2 year old. My question is whether or not we should wait until I get the swine flu vaccine or if we should continue to try? Also, what trimester is safest to receive the vaccine, if I do become pregnant before getting the vaccine? Thanks for your insight!
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Hi Candice, Thanks for your great question and I wish you much happiness on expanding your family.
It is perfectly fine to keep trying for your second baby, even before you receive the vaccine. The vaccine (shot) is a killed version of the virus so you are not at risk for becoming ill with it. The nasal drop version of the vaccine is a live virus and you should not receive that one at any time during pregnancy or while you are trying to conceive. It is safe to receive the H1N1 (Swine flu) vaccine during any trimester of pregnancy. I do recommend that you get the vaccine as soon as possible, when it becomes available.
If you haven’t already, please take a look at my Sept.24th blog post specifically on the H1N1 vaccine. I wish you all the best.
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My wife is 24 weeks pregnant with twin girls. She is 41 years old, and we have a 3-year-old boy through natural conception. The twins were conceived through in-vitro fertilization.
My question is this: My wife is very depressed and anxious, and her obstetrician has prescribed Ativan, in what he describes as a very low dose. Is this common, and is it safe? My wife’s family has said that she should just “snap out of it.” How can I deal with them, and how can I assure her that she will be okay? Prior to this pregnancy, she never had these kinds of problems.
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Depression or anxiety before, during, or after pregnancy is a real medical condition that can happen to any woman, for a wide variety of reasons. Your wife might be feeling extremely overwhelmed at having twins when she already has a young child. Also, the powerful pregnancy hormones her body is producing may be causing major mood changes.
Ativan, or lorazepam, is an antianxiety drug often used briefly in pregnancy. Especially if the dose is low, the benefits probably outweigh the risks. I strongly suggest, however, that your wife ask her obstetrician for a referral to a mentalhealth professional, who will have more expertise in current treatments for depression and anxiety. Talking with another woman who has experienced depression during pregnancy or after birth might be very helpful for your wife as well. As for your wife’s family, you can tell them that a person can’t just “snap out” of depression and that the condition can be life threatening. Remind them that your wife is under a doctor’s care, and assure them that she is being helped.
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A breech baby is positioned buttocks-down rather than head-down in the uterus. The type of breech depends on where the baby’s legs are. Let me explain the variations: Complete breech. The baby is in a sitting position, with his legs crossed. Frank breech. The baby’s legs are straight up, folded flat against his face. His arms may be around the legs. Footling breech. One leg is fully extended; the other is folded under. Double footling breech. Both legs are fully extended. Another unusual position is transverse. In this case, the baby lies horizontally, across the uterus. Babies move around a great deal in the uterus and are likely to be in many positions over the course of a pregnancy. Your baby could have been in a complete breech position at one time and could have extended a leg into a footling position at another time.
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There is no time when lifting is absolutely safe or unsafe. If you aren’t under any medical limitations, you can follow these guidelines. During the first trimester, you can do whatever you did before your pregnancy. For example, if you were comfortably able to lift 30 pounds before, then you could still do so, unless you are feeling too fatigued. Good body mechanics and back-saving techniques are always important: Bend at the knees rather than the waist to lift a heavy object. During the second trimester, you will probably feel more energetic, so this may be the best time for projects such as rearranging the furniture and decorating. You can lift things carefully, keeping in mind that your center of gravity has changed and that you will be less balanced in certain positions. I recommend against lifting any amount of weight that causes you to strain. During your third trimester, it is best to leave the lifting to others. You need to reserve your energy and strength, and at this stage, it is much more difficult to maintain balance when lifting. If you must lift something heavy, have another person help you, and never lift more than you comfortably can.
If you are going to be moving into a new home or renovating the current one, it’s best to get resettled a couple of months before the baby arrives. If you must take on a physically demanding project in late pregnancy, obtain as much help as you can get. You might invite over a group of friends, supply the pizza and sodas or beer, and have a party while getting the heavy work done. This can make for some happy memories after the baby is born.
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Babies have activity cycles just as we do. They can be more active or less so at different times of the day. Within an hour, they will have, on average, one 20-minute sleep cycle. They move more during the hour or so after Mom has eaten a meal, in response to the rise in her blood sugar. You may notice a few more punches, rolls, or kicks during that time.
Many women say that they feel their babies move the most at night. This could be because the baby starts moving when you stop or because you simply notice the baby’s movements more when you slow down.
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I’m having a minor panic attack! I have just been prescribed full bed rest and Brethine because of preterm labor. My doctor assured me that this is an appropriate, safe medication, but someone on an e-mail list told me that Brethine is not approved by the U.S. Food and Drug Administration for use by pregnant women, and that it causes all kinds of problems in the baby, especially gastrointestinal.
Is this true? Now I don’t know what to think, and I’m terrified that my baby might be harmed by this medication.
Please help!
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Brethine, also known by its generic name terbutaline, is a medication used primarily to treat asthma. It has also been found to be highly effective in stopping preterm uterine contractions. It works on asthma by relaxing the muscles of the lungs; for preterm labor, it has a similar effect on the muscles of the uterus. This drug does have side effects: It speeds up the mother’s and baby’s heart rates, and it can cause nausea, flushing, and nervousness. These symptoms generally are bothersome for the first few days only. Rarely are severe complications seen.
You are correct that the Food and Drug Administration (FDA) has not approved this drug for pregnancy, but FDA approval for medications takes many years. This medication, like many others, has been used in Europe for preterm labor for years. Studies have shown no increased incidence of short- or long-term developmental problems in children whose mothers were given terbutaline in pregnancy. Whenever the use of medication is considered, it is important to weigh the benefits against the risks. Premature birth can cause a baby significantly more complications than can taking this medication to delay the birth. Always remember to have your practitioner validate medical information that you hear from friends, relatives, or people you encounter on the Internet. Inaccurate information can bring more worry than help.
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I have recently heard some frightening stories about miscarriages occurring in the fourth or fifth month. I thought my miscarriage worries were over after 12 weeks! I’ve read that sometimes the initial symptoms are very subtle, just a slight pressure and a slightly heavier discharge. Well… how slight? I’m in my seventeenth week, and my abdomen sometimes feels heavy. I find myself wanting to hold it up. Is this just a normal symptom of pregnancy?
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The thought of miscarriage is always frightening, and a little information can cause much needless worry. Very often, a brief description of a pregnancy complication in a book or on the Internet turns out to be more upsetting than useful. Although second-trimester losses do occur, they are unusual, and they are very often related to an already known problem with the pregnancy.
One possible cause of late miscarriage is preterm labor. The symptoms of preterm labor can be subtle, since the cervix can dilate, or open, and efface, or thin, with or without painful uterine contractions. But usually, these cervical changes are accompanied by frequent, rhythmic uterine contractions that feel like menstrual cramps or are more painful. Any such contractions before your 37th week of pregnancy should be reported to your practitioner. Feeling pressure from your growing uterus is quite normal.
After about 30 weeks, so are mild contractions, called Braxton-Hicks. You may also feel your uterine (round) ligaments stretching, or you may notice some fetal movement that seems different, or “tight.” These normal feelings are sometimes mistaken for labor contractions. Try not to worry about every new sensation during pregnancy. If you are concerned, talk with your doctor or midwife. He or she is a far better source of information and reassurance than your next-door neighbor or the woman in front of you in the grocery line.
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In the early stages of pregnancy, as the embryo settles into the uterus, the placenta usually forms in the upper portion of the uterus. This area is called the fundus. With a lowlying placenta, however, the placenta forms in a lower portion of the uterus. This is a problem only if the placenta covers all or part of the cervix. If the entire cervix is covered, the condition is called placenta previa. It is not safe to deliver the baby vaginally when the mother has placenta previa, since the passing of the placenta first could cause serious bleeding in both mom and baby. In this case, a cesarean is needed. Generally, however, a low-lying placenta moves up and away from the cervix as the uterus expands. Although the placenta is attached to the uterine wall, the expanding uterine muscle shifts the placenta upward.
Because a low-lying placenta can cause bleeding, your doctor may have already placed you on “pelvic rest.” You will have an ultrasound scan later in your pregnancy to determine where your placenta is positioned. If it is out of the way of the cervix, you can resume your normal activities, including sex, and you can expect to deliver your baby safely vaginally.
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Getting sick while you are pregnant isn’t fair! Colds can be especially bothersome if your sinuses are already feeling stuffy from the extra blood flow you now have. You mentioned both antihistamines and decongestants. Let me differentiate them. An antihistamine relieves the itchy, watery eyes, sneezing, and other symptoms of environmental allergies such as hay fever. Diphenhydramine (Benadryl) is an example of an antihistamine. A decongestant relieves the stuffy nose and ear congestion frequently caused by a common-cold virus or sinus inflammation (sinusitis). A typical decongestant is pseudoephedrine, which comes under a variety of brand names. Pseudoephedrine is considered safe for use during pregnancy. Until recently, this drug was readily available on grocery and drugstore shelves.
Currently, pseudoephedrine products are kept out of reach of shoppers and available only on request. This is because pseudoephedrine is used in the illegal manufacturing of methamphetamine. Although no prescription is necessary in most states, you will have to show your driver’s license or other personal identification to buy the drug. Some cold medication manufacturers have replaced pseudoephedrine with phenylephrine, but many people feel that the replacement does not work as well. Nor has the use of phenylephrine during pregnancy been as well studied as that of pseudoephedrine.
Please talk to your doctor or midwife before taking any of these medications. If you are having aches or a fever, your practitioner may suggest that you take acetaminophen instead. In any case, you should rest as much as possible.
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I am 23 weeks pregnant. A couple of weeks ago, I lifted my four-year-old and had a very painful, stretching feeling in the middle of my abdomen. I called the doctor, who said that it was probably the ligaments that hold up my uterus stretching. A few days later, the pain happened again, several times, when I would stretch or move in an unusual way. Now it happens when I walk the dog or reach for something, or even when I am sitting still. It feels like a spasm, and it actually makes me jump! Do you think I should call the doctor again?
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It sounds to me as if you are experiencing round-ligament pain. On both sides of your uterus are ligaments, called round ligaments, that help to support it. As your uterus grows, these ligaments stretch. The stretching may cause a sharp twinge or pain when you move suddenly, turn, cough, or sneeze. The pains often occur over a period when a baby is having a growth spurt. Round-ligament pain is perfectly normal and nothing to worry about. It is another one of those uncomfortable conditions of pregnancy that will go away as soon as the baby is born.
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My husband and I are scheduled to fly for three hours to visit his family. I will be 17 weeks along, and I’m scared to death that something may happen, like turbulence on the plane, or that I’ll just feel lousy the whole time. The visit will be only for a weekend, but even at home, I am uncomfortable and have trouble sleeping.
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If your pregnancy is normal and your practitioner hasn’t told you otherwise, flying at 17 weeks should be safe. Doctors and midwives discourage air travel after 36 weeks, but this is only because of the risk that a woman could go into labor during her trip.
Your letter implies, though, that either you dislike flying or you just don’t want to take this trip. Only you can decide what you’ll be comfortable doing. Discuss your feelings with your husband, and if you decide to go, be sure that he will give you the support you need. Plan to take a lot of deep breaths during the flight, allow plenty of time for rest once you arrive, and relax as much as you are able. If talking with your husband doesn’t relieve your anxiety, perhaps it is best to postpone the visit until after the baby is born.
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I was told by an ultrasound technician that I have an anterior placenta. What exactly is this? Is it why the baby’s heartbeat is sometimes hard to find, and why I don’t feel as much movement as other women who are 19 weeks along? Also, does my being overweight make it harder to feel the baby kicking?
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A placenta can implant in any number of places, including at the top of the uterus (the fundus), at the back of the uterus (posterior), or, in the case of placenta previa, in the lower portion of your uterus, covering your cervix. Having an anterior placenta means that it has implanted along the front portion of your uterus, directly under your belly button. An anterior placenta is perfectly normal, and yes, it is the reason you do not feel the baby’s movements as much as other women do. Instead of kicking directly against your abdominal muscles, the baby is kicking and pushing against the placenta. This softens the impact for you, as if you were cushioned by a pillow inside. This is also why it is sometimes hard to locate your baby’s heart-beat. My Alexander had an anterior placenta, and I was a bit disappointed that I did not feel him moving around much. If you have a layer of fat on your abdomen, this further cushions the baby’s movements.
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Yes, you should get the flu shot this year. Pregnancy can decrease your immunity and so put you at increased risk of getting the flu. Pregnant women are also at greater-than-average risk of developing serious complications of the flu, such as pneumonia. If you were to get the flu when your baby was a newborn, your baby might get it, too. The vaccine contains three influenza viruses that have been identified as likely to cause widespread infection in a given year. Your body takes about two weeks after you receive the vaccine to develop antibodies to the influenza viruses. Knowing that the flu season is at its height from December through March, the Centers for Disease Control and Prevention recommend that pregnant women be vaccinated in September or October.
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I am 18 weeks pregnant, and I have been having some vaginal bleeding and contractions. I am scheduled for an ultrasound check next week. My doctor told me that in the meantime, I should decrease my activities at home. He said something about “pelvic rest,” which I thought meant no sex, but now I am not sure. I am too embarrassed to call and ask him what it means. Can you help?
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You are certainly not alone in wondering what “pelvic rest” means, or feeling uncomfortable about asking a doctor for details of what you may and may not do sexually. Being on pelvic rest means you shouldn’t do anything that might cause or increase bleeding or contractions. That means you need to adhere to the following guidelines: Nothing in the vagina. This includes tampons, penis, or fingers; No orgasms (for you). They can cause contractions, so even oral sex and masturbation are out; No breast stimulation. Stimulating the breasts releases the hormone oxytocin, which can cause contractions. Once you have your ultrasound, your doctor will learn more about what may be causing the bleeding.
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Pregnancy-induced hypertension is an older term that is sometimes used interchangeably with preeclampsia. If you have high blood pressure and not the other symptoms of preeclampsia (swelling and protein in the urine), your doctor may refer to your condition as chronic hypertension. Any of these terms means that your blood pressure is too high.
One in five pregnant women spends a week or more of her pregnancy on bed rest, as treatment for any of several things—preterm labor, vaginal bleeding, placenta previa, preeclampsia, chronic high blood pressure, sciatic pain. A milder treatment for some of the same conditions is “decreased activity”—staying home most of the time, avoiding exercise, and putting your feet up for a while several times a day. Bed rest is usually prescribed with a qualifying term—partial, moderate, or strict:
Strict bed rest. You must remain in bed (or on the couch, if your doctor approves) at least 23 hours a day. You are allowed a shower only every other day, and you must remain on your side throughout all your meals. Your food, drink, and anything else you may need must be brought to you. You can get up very briefly to use the bathroom or a bedside commode, but not for any other reason. If you are at home on strict bed rest, remember that your next stop is the hospital! Knowing this may help you follow the rules at home.
Your doctor or midwife may have his or her own particular rules regarding bed rest. Follow your practitioner’s specifications; your health and your baby’s health may depend on it.
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The truth about embarrassing questions is that they often are the ones everyone has. Anything that passes through the baby’s body ends up being part of the amniotic fluid. Your baby’s urine is made up of products different from ours. The more urine your baby produces, the more amniotic fluid you have. Since your baby is not digesting any food, she is not yet having any bowel movements. Shortly before birth, however, your baby may pass a bowel movement in your womb. This first stool, called meconium, is very sticky and dark green. Meconium is ordinarily first passed in the initial few hours after birth. A baby’s passing of meconium before birth can mean that she is postmature (past 41 weeks’ gestation) or has been under some kind of stress. If you notice a greenish or dark yellowish vaginal discharge, please let your practitioner know. This could mean that your water bag has broken and that the baby has passed meconium. Your doctor or midwife will want you to come into the hospital or birth center, so that you can be checked.
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Could you tell me a little about sciatica in pregnancy? What causes it? What makes it worse? What helps eliminate it? What can you do to keep it from flaring up? Once you get it, does it last the entire pregnancy? And why do you only get it on one side or the other? Mine began at 22 weeks. At first, it felt like just a burning sensation in the buttocks, but if I do much walking, I also get shooting pains down my leg.
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Sciatic pain—or sciatica, as it is sometimes called—is probably one of the most painful conditions associated with pregnancy. Your sciatic nerve is the largest nerve in your body. It passes from your pelvis on either side and down the back of your thigh, where it divides into smaller nerves. You can pinch and injure the nerve in many ways; during pregnancy, however, compression of the nerve from the baby’s position is the most likely cause of sciatic pain. You are probably feeling the pain on the side where the compression is.
Although you can’t prevent sciatic pain, you may notice that certain positions and activities will either aggravate it or make it better. Sciatica can be completely debilitating when it flares up. Warm or cold packs, physical therapy exercises, pillows under your hip, and lying with your hips elevated may all help to relieve the discomfort, though none of these is a sure bet. Sciatica usually does not last throughout the entire pregnancy; it often disappears completely when the baby changes position. If this doesn’t happen, your sciatic pain should resolve completely when the baby is born.
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I am 30 weeks pregnant, and I’ve noticed little pimples that erupted just outside my vagina and that are starting to itch. I have had genital herpes before (although I haven’t had an outbreak for a couple of years), and I believe it may be back. Should I be concerned, should I take anything, or should I just wait for the eruption to go away? I know this could be a problem if I were about to go into labor, but that isn’t the case. What are the concerns at this point in my pregnancy?
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Any time you experience some new or unusual physical condition, whether you are pregnant or not, it is important to have a doctor or another medical practitioner check it out. Your symptoms may indicate genital herpes or another condition that should be treated. Let your practitioner know that you have had genital herpes outbreaks before. Genital herpes is a sexually transmitted infection caused by the herpes simplex virus. Between 20 and 25 percent of pregnant women have genital herpes. Women who have outbreaks in the third trimester or at birth risk transmitting the virus to their babies, for whom the infection could be life threatening. A cesarean is the only way these women can safely deliver their babies. If you have a genital herpes lesion, it will not cause any problem as long as it heals within the next couple of weeks. Your doctor or midwife should discuss treatment options with you. Some antiviral drugs are considered safe to use in pregnancy, and new information about such drugs is becoming available all the time.
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Pets pose few dangers during pregnancy or childhood. Of course, they must be kept healthy and clean. Dogs and cats should be appropriately vaccinated. All the animals must be friendly and safe for children to be around, and even a friendly dog shouldn’t be left alone with a baby or toddler. Animals that do not tolerate children well should not be part of a human family. Most cats pay little attention to a baby. Your cats need to know, though, that the baby’s bed is not a place for them to be. Once your baby is crawling and walking, make sure that the litter box is tucked away somewhere where he can’t get to it. As your child grows, teach him to wash his hands thoroughly after handling any pet.
Lastly, enjoy your animals. They are a part of your family, and by growing up with them, your child will learn to love all of nature’s creatures.
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I am 35 weeks pregnant, and I have been said to be at high risk of complications because I have gestational diabetes and take insulin.
My doctor now wants me to have a “biophysical profile.”
What is this, and why is it done? Is it routinely done, or is this unusual? What other types of testing are done at this stage of pregnancy?-
Fetal testing such as a biophysical profile at this stage is not routine. It is done for a specific reason, such as to check the well-being of an overdue baby (at 41 weeks or beyond) or to assess the functionality of the placenta. Because you have gestational diabetes, your doctor wants to watch the baby extra closely during these last weeks of your pregnancy.
A biophysical profile uses ultrasound and takes from 20 to 60 minutes to complete. The baby is scored between zero and two points for each part. A total score below eight indicates a need for further testing. The least common of the three tests, a Doppler flow study, uses ultrasound to assess the rate of blood flow in the umbilical blood vein and in the baby’s arteries, brain, and heart. The procedure is much like a regular ultrasound exam, except that the test uses color to differentiate the blood vessels. Waveforms on an ultrasound screen show variations in the rate of the blood flow. Decreased flow may indicate that the baby is not receiving enough blood, nutrients, and oxygen from the placenta.
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The common term for this event, lightening, doesn’t quite convey what actually happens: The baby’s head descends into the pelvis. Because of decreased pressure on the diaphragm and stomach, you will indeed feel “lightened” when your baby drops, and your breathing and digestion will become easier. You’ll probably also feel the need to urinate more often, however, and you may feel pressure or aches and pains in your pelvic joints and perineum. You’ll notice a change in the shape of your abdomen; the bulge will have shifted down and forward. If this is your first baby, lightening may occur about two weeks before labor starts. In women who have given birth before, the baby often doesn’t drop until labor begins.
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I had twin girls four years ago. When I was pregnant, I was told they were in separate sacs and therefore not identical. Once they were born, the doctor said they might be identical, because they had the same blood type. They look very much alike, and I am asked all the time if they are identical. Is there any way to know for sure whether they are identical or fraternal?
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Identical twins occur when one egg divides into two, so that the babies have the same genetic makeup. Fraternal twins occur when two separate eggs are fertilized. Like fraternal twins, identical twins normally have two separate amniotic sacs. It is extremely rare for these twins to share one sac, and dangerous, too, since the babies’ umbilical cords could get entangled during the pregnancy. Your girls could indeed be identical, especially if they look a great deal alike. The fact that they have the same blood type isn’t a clear indication, as it is quite common for siblings within any family to have the same blood type. The only way to know for certain is to have the girls genetically tested. Their doctor should be able to help you find out how to do this and the costs involved.
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I’ve been receiving conflicting opinions concerning childbirth classes, specifically Lamaze. I am 61/2 months pregnant with my 170 first baby and would like to know your views on the subject. Is a program like Lamaze helpful if I’m planning to use an epidural? I am from Sweden, and in my country, this doesn’t seem to be such a big issue. I don’t want to take the classes just because it’s expected.
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All labor involves some pain. Even though you wish to have an epidural, it is very important to learn about alternative ways of dealing with labor pain, and books simply cannot teach you the coping skills the way a class can. Whether your childbirth class involves Lamaze breathing and relaxation techniques or other approaches to childbirth, the class should incorporate discussions of natural methods of coping with pain as well as medication options.
As with all types of education, childbirth classes are taught by some great teachers and some not-so-great teachers, but in general these classes are extremely helpful as preparation for labor and birth. Your course should help you understand what will happen with your body in labor and how to work with this natural process. Your teacher should tell you what you need to know so that you won’t be afraid of what your body is going through and so that you can make informed choices in labor. The classes provide this information in an open, accepting atmosphere in which you feel your questions are welcome. A good instructor will teach you to be flexible, because labor is always somewhat unpredictable, and will help you to feel supported, confident, and capable. By taking the classes, you will be better prepared to have a positive birth experience, whether you end up giving birth vaginally with an epidural, having a non-medicated birth at home, or having a planned or unplanned cesarean. Finally, by emphasizing that there is no right or better way to give birth, your instructor will dispel any anxiety or guilt you may feel about your choices.
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As your baby and your uterus grow, the pressure upward on your stomach increases. This causes stomach acids to back up into your esophagus. The condition may also cause Breech Position Transverse Position sudden vomiting, without the lingering nausea that is usual with morning sickness.
Be sure you let your practitioner know about this problem. He or she may recommend an antacid and offer some additional suggestions for relief.
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Midwives care for healthy women who have low-risk pregnancies and uncomplicated deliveries. The philosophy of midwifery is to encourage as natural a labor as possible and to provide continuous support for the laboring woman. Besides typically being present for a longer period during labor than a physician would be, midwives favor low medical intervention. In the hospital, however, they support a women’s choice to have epidural anesthesia, and they use other interventions or bring in an obstetrician when necessary.
Certified nurse-midwives (CNMs) frequently share a practice with one or more physicians and consult with them as needed. Having your care provided by a CNM may be more affordable than using a physician. Whether a midwife would be better for you, though, may depend on the level of care you need. In many countries, midwives manage most normal births and leave cesarean or complicated births to their physician colleagues.
Whether to use a physician or midwife is a personal decision. I encourage you to make the choice that feels right for you.
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I am pregnant with my second child. My first child was born by cesarean section under general anesthesia because of fetal distress. For this second baby, I will be having another cesarean, but my doctor told me that he would rather I have a spinal anesthetic than go to sleep. My question is this: Are there any side effects from a spinal? The thought of a needle going near my spine is quite scary!
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Except in emergencies, spinal anesthesia is usually preferred over general anesthesia for cesarean births. General anesthesia has no long-term effects on babies, but if they are exposed to it in the uterus for more than a few minutes, they can be quite sleepy at birth. Spinal anesthesia works quickly and lasts for only a couple of hours. It is very safe for the baby.
The thought of a needle in the back can be frightening. I hope that by explaining the process of spinal anesthesia, I can ease your fears about it. An anesthesiologist administers a spinal anesthetic by placing a specially designed needle through the membrane outside your spinal fluid in the lumbar region of your back (well below the end of your spinal cord.) The doctor injects a numbing medication directly into the spinal fluid. A spinal differs from an epidural in that, with a spinal, the needle passes through the membrane where the spinal fluid is; with an epidural, it does not. Also, with an epidural a tiny catheter is inserted. This allows more doses to be given for longer pain relief. Both procedures produce numbing from the breasts or belly button down to your toes.
Fewer than 4 percent of women who have spinal anesthesia get a “spinal headache,” which occurs after a small amount of spinal fluid leaks out. This problem is corrected with a “blood patch,” in which a small amount of the woman’s own blood is injected into the area.
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Women everywhere understand how you feel. I have some ideas for you. They are simple, and they come from the experts, women like you who have been waiting, waiting, waiting: Visit a new or elegant restaurant; Catch up on the latest movies, or enjoy old classics; Swim; Make a couple of stews or casseroles, and freeze them for after the baby is born; Have lunch with a friend; Treat yourself to a massage; Make a list of numbers to call when the baby is born; Spend a romantic night or weekend in a hotel with your partner; Take a bubble bath; Shop for yourself, not the baby; Buy some fresh flowers; Bake cookies or bread; Visit a local museum; Read a good book that’s not about birth or babies; Write a letter to someone you don’t see often enough; Go to a concert; Go dancing with your partner; Play with your pet, as it may sense that change is coming; Ask your mate for a foot rub; Go to the beach; Spend an evening cuddling in front of a fire with your sweetie; Have your partner take some sexy and silly photos of your pregnant body; Look at your baby pictures and your partner’s; Savor being two before you become three!
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Cesarean sections are performed differently today from when your mother had her babies. The surgery requires two incisions, one through the mother’s skin and the other in the mother’s uterus. When your mom had her cesareans, her uterine incision was probably vertical, or classical. Today, cesareans are performed with horizontal uterine and skin incisions. A horizontal uterine incision is called low transverse. As several studies confirmed in the early 1990s, this type of incision makes it safe to attempt a vaginal birth after cesarean (VBAC) with a second pregnancy. More recent studies have found a small risk—1 chance in 200 to 400—of the uterus’s tearing during VBAC with a horizontal incision. (The risk is much greater after multiple cesareans.) Because of these latter findings, the trend toward repeat cesarean sections has increased in recent years. Yet many women still choose VBAC, and 70 percent of those who do elect this type of delivery succeed in delivering vaginally.
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I’ve heard that only a small percentage of women actually have their “bag of waters” break prior to labor. With my first child, my amniotic sac ruptured at 29 weeks and I delivered at 31 weeks.
There was no known cause, such as infection, for the premature rupture. Now I am 32 weeks along in my second pregnancy, and preterm labor began in my 26th week. I am doing very well, taking terbutaline tablets, and staying on bed rest. Could my water bag break before this baby’s birth, too?
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Your question concerns two topics: the rupture of the water bag (amniotic sac) before labor begins, and premature labor. Let’s address these two separately. In the movies, labor always seems to begin with the breaking of the water bag. But labor actually begins this way for only 10 to 15 percent of women. When it does, it usually happens at full term, between 37 and 41 weeks. Labor seldom begins before 37 weeks. But when it does, it often begins with rupture of the membranes. Sometimes, there has been a mild infection in the uterus and amniotic sac. This condition, called chorioamnionitis, can be difficult to diagnose and treat. In other cases, undiagnosed cervical dilation has caused the amniotic sac to break. In still others, the amniotic membrane was weak for some reason.
The fact that your water bag ruptured prematurely in your first pregnancy does not necessarily mean it will this time. Although both the premature birth of your first baby and the premature labor you have experienced in this pregnancy increase the likelihood that you’ll deliver prematurely again, the terbutaline and bed rest appear to be working well for you. Hang in there for just a few more weeks!
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A trained labor assistant, or doula (from a Greek word for “woman’s helper”) provides continuous physical, emotional, and informational support to mothers and their partners during labor and birth. Studies have shown that continuous labor support decreases the use of pain medication, epidural anesthesia, episiotomies, and cesarean sections and provides greater feelings of control and satisfaction for women in labor.
A doula would play a unique role on your birth team. She would not replace your own loving support for your partner. Instead, she could help both of you by offering suggestions about comfort measures—such as relaxation, visualization, breathing, massage, aromatherapy, use of a birthing ball, and spending time in the tub or shower—and assistance in carrying out these measures. She would not influence any medical decisions that you and your partner may need to make, but she could help you figure out what questions to ask of your practitioner and your nurse to help you in making these decisions. Each person on the birth team has different responsibilities, and everyone working together makes the amazing dance of labor a very positive experience for the mother and her partner.
The cost of using a doula can vary a great deal. The community hospital in my neighborhood provides free doula services to women who have no partner, friend, or relative to accompany them in labor. Doulas usually charge for their work, however, and I have seen fees ranging from $350 to more than $1,000. Fortunately, some insurance companies are reimbursing couples for a portion of a doula’s fee. You may want to check with your insurance provider.
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My partner, who is about nine weeks pregnant, does research in environmental chemistry in a laboratory at her university. I am concerned about the chemicals she is in contact with every day. What chemicals might be harmful to our baby, and what precautions should she take if she is working with these chemicals?
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Your partner’s employer should have a list of all the chemicals that are used in the workplace. Those that are dangerous to pregnant or lactating women should be posted, and she should not have contact with them. If you have any questions about this, you can contact the Occupational Safety and Health Administration (OSHA), 200 Constitution Avenue NW, Washington, DC 20210. The OSHA website, http://www.osha.gov, is also an excellent source of information.
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Many physicians now have ultrasound scanners in their offices. With these machines, it is usually possible to see the baby’s heart beating at 6 to 8 weeks. Most ultrasound scanners have amplifiers, so you can hear as well as see the heartbeat by this early date. If your doctor or midwife doesn’t have an ultrasound scanner, he or she will listen with a Doppler, a small, ultrasonic device that amplifies the sound of the baby’s heartbeat. With a Doppler, it’s sometimes possible to hear the baby’s heartbeat at 6 to 8 weeks, but it’s much easier to do so at 11 or 12 weeks.
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You may be having symptoms of carpal tunnel syndrome. Although this condition occurs most commonly in women between 40 and 60 years old, often as a result of repetitive movements of the wrists and hands, it also occurs in as many as 25 percent of pregnant women. In pregnancy, hormonal effects, swelling, and weight gain can compress the nerve inside the carpal tunnel, which is a sheath of tissue surrounding the median nerve. This nerve supplies the thumb, the first two fingers, and half of the ring finger. The symptoms of carpal tunnel syndrome are numbness, tingling, pain, and often a burning sensation in these areas, on one or both hands. Treatment includes wearing a wrist splint at night and during activities that make the symptoms worse, such as driving a car or holding a book. You may also be able to relieve the discomfort by rubbing or shaking your hands. Although the symptoms of carpal tunnel syndrome can be disturbing, they almost always disappear after the baby is born.
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PUPPP stands for pruritic urticarial papules and plaques of pregnancy (say that ten times quickly!). Among the many skin rashes that can develop during pregnancy, this one most commonly occurs in abdominal stretch marks but can also occur on the buttocks, thighs, and arms. As you know, PUPPP is itchy, itchy, and itchier. Its cause is unknown, but PUPPP is not a serious condition; it poses no danger to you or your baby. It lasts about six weeks, on average, and disappears within two weeks after birth. It generally doesn’t recur, even in subsequent pregnancies.
To lessen the itching, you can try taking oatmeal baths or use an over-the-counter anti-itch cream containing 1 percent hydrocortisone. If this doesn’t help, your doctor or midwife may suggest an antihistamine or, if the itching is very severe, a corticosteroid.
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Although I tried to lose weight before conceiving, I started pregnancy nearly 40 pounds overweight. My doctor has told me that I do not need to gain any weight and that I should just try not to lose any. He has given me suggestions about sensible eating, and I am committed to following them. Besides eating well, I am walking a great deal. I know that much of the weight gained in pregnancy goes to the placenta, baby, extra blood flow, and fluid. How, then, is it possible for overweight women not to gain?
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It is wonderful that you have a sensible approach to weight and nutrition and that you are doing everything possible to keep yourself and your baby healthy.
Obesity in pregnancy is associated with a higher incidence of hypertension (high blood pressure), preeclampsia, gestational diabetes, and macrosomic babies (heavier than 91⁄2 pounds). Poor eating habits can cause obese women to gain even more weight in pregnancy. But overweight women who eat sensibly often discover that they gain very little during pregnancy. With proper diet and exercise, the body redistributes some of the weight. Some of the existing fat stores are used for the baby, the placenta, and breast tissue. This can happen without extreme dieting. It’s important, in fact, not to strictly limit calories during pregnancy nd while you are breastfeeding.
If you need help in managing your weight, ask your doctor about visiting with a dietitian or nutritionist. He or she can help you develop a healthy approach to eating and nutritious meal plans.
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Help! My mother was recently exposed to fifth disease. I’m seven months pregnant, and I have been advised to stay away from my mother. I had never heard of fifth disease before; it’s not even mentioned in the books I’ve looked at. What are the symptoms, how dangerous could it be to my baby, and what should I do now?
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Fifth disease, caused by a parvovirus, is so called because it is the fifth in a group of six childhood diseases that cause rash and fever. The symptoms of rash and fever are generally mild and frequently go unnoticed. It is uncommon to develop fifth disease during pregnancy. Most women are in fact immune, having been infected as children without being aware of the infection.
Very rarely, infection with fifth disease during pregnancy increases the risk of an early miscarriage or a rare form of fetal anemia. It is best to follow your practitioner’s advice in your situation, but you and your baby are likely to be completely unaffected.
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About Tori Kropp
Known as "the Dear Abby of pregnancy," Tori has been interviewed on national television and radio and in national print publications, including CNN, The Wall Street Journal, New York Post, Washington Times, Atlanta Journal Constitution and Chicago Sun-Times.
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Ask Your Question
Hi Tori:
I’m early in my first trimester (7wks) and have a mild yeast infection. Are there treatments that are safe for me to use/take at this time? I’ve heard that you can use garlic or unsweetened yogurt but want to be sure that they’re safe during pregnancy. I was also thinking of taking acidophilus supplements. Are those safe during pregnancy?
Thanks,
Maggie