User:Jocey/Sandbox/Preg

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[edit] Pregnancy & Childbirth

This Vulvapedia entry focuses on pregnancy and childbirth. If you are looking for advice on how to handle an unplanned pregnancy that you are not sure you wish to carry to term, we invite you to visit VaginaPagina on LiveJournal or the LiveJournal community PregnancyChoice for more information. The information contained in this Vulvapedia entry may be helpful to anyone wanting to know more about what pregnancy entails, whether or not s/he is pregnant or wishes to carry a pregnancy to term.

Contents


[edit] How does pregnancy happen?

To understand how pregnancy occurs, it helps to understand how the menstrual cycle works. A woman will typically ovulate once per menstrual cycle, barring any medications which prevent ovulation or any conditions (like endometriosis or polycystic ovarian syndrome), and it is the time just following ovulation that fertilization is possible. Pregnancy occurs when a fertilized ova (or egg) implants in the uterine wall. In order for fertilization to occur, the egg must meet up with a sperm cell at some point. This may occur as the result of sexual intercourse, from artificial insemination, or even in a petri dish in a fertility clinic.

[edit] What are some of the early signs of pregnancy?

Some common signs include:

  • abdominal cramping (sometimes surprisingly strong cramping)
  • mood changes
  • breast tenderness
  • food cravings or aversions
  • nausea
  • yeast infections, or YI-like symptoms

The following sites all have more information about early pregnancy symptoms:

[edit] I'm having some of those symptoms, but how can I know for sure that I'm pregnant?

It's important to note that the presence or absence of any of these symptoms listed above is not a valid indicator of pregnancy -- the only real way to know if you are indeed pregnant is to take a pregnancy test.

[edit] How/Where do I take a pregnancy test?

You can test at home, via a kit purchased at a pharmacy or other store, or you can test at a health care facility – doctor’s office or clinic. With a home test, it’s recommended to use your first day’s urine, which will be more concentrated and have more of the pregnancy hormone (HCG) if that hormone is indeed present in your body. The site PeeOnAStick.com has a great deal of information about home pregnancy tests that may prove helpful to you.

[edit] Is there anything else I should know about pregnancy testing?

If you’ve a history of miscarriage or ectopic pregnancy (pregnancy which takes place outside the uterus, usually in the fallopian tube, is not viable, and can be extremely dangerous to your health), your health care provider may order serial blood tests to check your hormone levels. These tests detect the pregnancy hormone (HCG) and enable your health care provider to ensure that the blood levels of this hormone are doubling every two days -- the sign of a healthy, viable pregnancy. These tests are not necessary for everyone though, so be sure to check with your provider to see if s/he thinks they make sense for you and your situation.

[edit] I'm definitely pregnant! What should I do now?

Once you have established that you are pregnant, sit back and relax!

Some of the things you'll want to do now:

  • Take prenatal vitamins (your health care provider can prescribe some, including specific brands which help combat pregnancy-related nausea, or you can find many varieties over-the-counter), as they can help combat neural tube defects like spina bifida.
  • Eat well, drink lots of water, and try to get enough rest – you may feel more tired than usual during this time.

Check out [link link | this section] for a preview of what's to come!

[edit] What medications are safe to take during pregnancy?

One of the questions health care providers hear quite often is “Can I take _______ during pregnancy?” You can certainly call your health care provider (most offices have nurse lines equipped to handle questions just like this) to ask about a specific medication you're wondering about, but you can also invest in a guide that you can refer to yourself – the most common guide on this topic is Hale’s. Many pregnancy communities like the Mothering Magazine website, BabyCenter, various LJ communities (see the Resources section at the end of this article for a few), and VaginaPagina.com/VP on LJ are also helpful and full of advice.

Below are some common ailments and some remedies for each that are safe to take while pregnant and/or breastfeeding. If the treatment you'd like to use isn't listed, or if you've tried those listed without success, you can give your health care provider a call to get more suggestions. (Note: Generic versions of the medications listed below are also safe to take.)

  • Allergies and Congestion

Over the Counter - Plain Sudafed (in the red box) or a generic version thereof, plain saline nasal spray
Prescription - Zyrtec, Flonase, Nasacort (or generic versions)

  • Cough

Robitussin DM (or generic version)

  • Constipation

Metamucil, Fibercon, Senokot, Colace, or Milk of Magnesia
Also, try increasing your intake of water and dietary fiber.

  • Diarrhea

Kaopectate or Immodium

  • Headaches

Tylenol/acetominophen
Also try drinking plenty of water!

  • Hemorrhoids

Tucks, Preparation H, Anusol

  • Heartburn/Indigestion

Maalox, Mylanta, Rolaids, Tums, Zantac, or Pepcid
Also try to stay hydrated and avoid foods likely to cause heartburn.

  • Itching/Skin Irritation

Aveeno, Cortaid/hydrocortisone cream, Bendadryl (cream or spray), Calamine

  • Nausea

Vitamin B6 (10-25mg), apricot, peach, or pear nectar, crackers, eating small, frequent meals, non-carbonated cola beverages, ginger tea, peppermint lozenges

  • Sore Throat

Chloraseptic spray

  • Yeast Infection

OTC treatments such as Monistat, one of the alternative treaments covered in the Vulvapedia entry on YIs

[edit] Do I need to go to the doctor right away?

Don't be concerned if your health care provider doesn't ask you to come in for a visit immediately. Most first obstetrical visits are at around eight or ten weeks, as that’s when the health care provider will be able to check ultrasound for fetal heart and ascertain viability of the pregnancy. This is important, because up to 20-25% of pregnancies are non-viable, and will end in miscarriage (usually early in pregnancy, but some later in gestation).

[edit] How do I know how far along I am?

Many women will calculate how pregnant they are based on when they would’ve conceived – either based on intercourse on a certain day, or based on an assumed date of ovulation. Modern medicine however, calculates pregnancy based on last menstrual period, or LMP. This is not foolproof, particularly if a woman has long or irregular menstrual cycles, so a health care provider may ask for additional information, such as a probable day of conception, length of other recent menstrual cycles. Your provider may also perform sonograms (also called ultrasounds) to calculate the gestational age of your embryo or fetus, based on developmental characteristics and crown-rump length. What is important to know though is that because your health care provider will be calculating based on LMP is that your gestational age may be more advanced than expected. You should also know that the average length of pregnancy from LMP to delivery (also called EDD or EDC) is 40 weeks – that is, ten months, rather than the nine months commonly associated with pregnancy.

[edit] So what's pregnancy like? What can I expect in general?

Pregnancy, like many things, is different for each person, but there are some general truths, some of which are discussed below. If you have any questions at any point during pregnancy (especially if you feel that something may be amiss!), you can always contact your health care provider, who will be able to answer based on your specific situation.

When talking about pregnancy, it helps to break the experience down into trimesters.

[edit] First Trimester

This is the time when you are ovulating, the ovum is being fertilized by sperm, and implantation is occurring. Most women will realize that they are pregnant during this time. You may experience signs and symptoms of pregnancy, and you may experience bloating – some women think this means you’re already “showing”, but that’s quite unlikely.

You may experience some of the symptoms of pregnancy. A common occurrence in the first trimester is morning sickness, which despite its name can occur at any time of day.

Some strategies for avoiding or minimizing morning sickness are:

  • staying well hydrated
  • trying to keep your blood sugar steady (some women find that spikes and valleys make the nausea worse)
  • taking extra vitamin B supplements, especially B6
  • changing the time you take your prenatal vitamins to just before bedtime
  • trying to increase consumption of ginger or peppermint
  • wearing sea bands, small bracelets which apply pressure to certain points on the wrist said to alleviate nausea.

If morning sickness is making you miserable and none of the above remedies are working, feel free to speak with your health care provider to learn about other strategies for dealing with it.

Source: http://www.4woman.gov/pregnancy/pregnancy/1st.cfm

Again, it’s very important that you are taking prenatal vitamins and taking care to avoid toxins during this time. It’s best to not take medications unless necessary and approved by a medical professional, as some may interfere with pregnancy and cause problems for you and the embryo.

During this time you will have your first visit or visits with a medical provider, as described below. At the end of this trimester your provider may recommend screening for Down’s syndrome and other chromosomal abnormalities. These first trimester screens are typically done via ultrasonography and blood tests. This Babycenter.com article explains more about first trimester combined screening.

[edit] What can I expect at the clinic?

  • Weeks 8-10

Your first visit will likely consist of a general check-up, including a Pap smear. Either this visit or your first visit will likely include a routine pap smear, gonorrhea and chlamydia testing, and blood work. Typically this blood work will include infection testing (for things like HIV and Syphilis, which can be very dangerous during and after pregnancy) and routine labs, like thyroid testing. Your health care provider will likely also check your blood type to see if you will require Rh antigen injections during pregnancy. S/he will probably test your blood pressure and check your weight at this visit and at all subsequent visits. Later in pregnancy, this routine check-up will probably also involve your provider measuring your belly and listening for your fetus's heart tones. At all visits, s/he can address any questions or concerns that you have.

  • Week 12

Routine check-up, and first trimester combined screening, which uses blood and ultrasound testing to screen for abnormalities.

[edit] Second Trimester

If you experienced morning sickness during your first trimester, this is the time when you will likely start feeling better. Cramping, mood swings, and morning sickness should subside during this time. This is also when you will likely begin to “show”, and will probably need to purchase maternity clothes (or simply wear larger clothes).

At around 16 weeks, your health care provider may recommend additional prenatal screening for neural tube defects and other concerns, as described here[linky linky].

During this time you will likely start to feel fetal movement – small, tiny flutters at first and then greater movements that others can see while watching your stomach.

[edit] What can I expect at the clinic?

  • Week 16

Routine check-up. At this time, your health care provider may recommend additional prenatal screening for neural tube defects and other concerns. This second trimester quad screen result may also be combined with your first trimester screening result, for an overall view of the health of your fetus.

  • Week 20

Routine check-up. At this visit, your health care provider may recommend an anatomy scan, which is a specific, extended ultrasound to count fingers and toes of your fetus. Your provider may also be able to tell you the sex of the fetus, if you want to find out.

  • Week 24

Routine check-up. At some time between now and your 28-week visit, your provider may recommend a glucose tolerance test, or sugar test, to screen for gestational diabetes. This test is typically done in the office, at a routine appointment. You will probably be asked to eat normally prior to the test, though to abstain from extremely sugary treats. You’ll be given a drink or other sugary substance to challenge your system, and you’ll have a blood draw usually one hour later.

[edit] Third Trimester

You’re nearly there! You may be feeling bigger and clumsier at this time. It’s important to speak with your health care provider regarding any concerns or questions, and to craft a birth plan with his or her guidance. You will also want to look into the facility you plan to birth at, and may be interested in birth classes and child care classes offered in your area. In this trimester, it’s all going to be about keeping yourself comfortable and preparing for the arrival of your baby. You should eat reasonably, and avoid foods which cause heartburn (a common occurrence at this stage in pregnancy) or constipation. You can exercise, but be aware that your center of gravity is likely to have shifted and you may tire much sooner. Listen to your body, and if something hurts, stop doing it!

You may feel signs of labor coming on. You may have had Braxton-Hicks contractions for weeks now, but they may increase in frequency, duration, and severity. Be sure to notify your health care provider if your contractions are 10 minutes or less apart and last for 30-60 seconds at a time, or if you have any sort of vaginal bleeding or abnormal discharge, or of course if your water breaks (you begin to leak amniotic fluid).

[edit] What can I expect at the clinic?

  • Week 28

Routine check-up, possibly accompanied by gestational diabetes screening described above.

  • Weeks 30-34

Routine check-ups approximately every two weeks.

  • Week 36

Routine check-up. At this time your provider may recommend a vaginal swab test for Group B strep. This is a normal bacterium that can live in the vagina, but can pose problems for the baby. It’s easy to test for with a simple swab, and a woman who tests positive will be treated with antibiotics during labor to avoid passing the bacteria to the baby during birth.

Appointment frequency will increase somewhat at this point!

  • Weeks 37-40

This is the home stretch! Your provider will likely want to see you on a weekly basis at this point. S/he will check your cervix for dilation and effacement, to see if you're near labor. Be sure to notify your health care provider if you experience contractions that are 10 minutes or less apart and last for 30-60 seconds at a time, or if you have any sort of vaginal bleeding or abnormal discharge, or of course if your water breaks.

[edit] Okay, what about labor -- what's that like?

There are three parts or stages of labor, each of which can be divided into phases.

[edit] Stage One

The first stage begins very quietly -- at first, you may not even realize that it is the beginning of labor! This is called early labor. Your contractions will likely be several minutes apart, and you will probably be resting comfortably at home. During early labor your cervix effaces, or thins out, and begins to dilate, or open.

The second, or active phase will begin when your cervix begins to dilate more rapidly and your contractions start to happen more frequently and last longer (a minute or so at a time). At this point you will likely want to be transported to wherever you plan to give birth, and will be concentrating on the task at hand. It's recommended that you stay mobile and active (within reason, or course) during the time between contractions, and save up your energy for the next stage.

Transition is the last phase of the first stage of labor. It may last an hour or two, and can be very intense indeed. Your contraction may be a minute or two apart and last a minute or two apiece. Support during this stage is crucial, so be sure to communicate with your birth partner ahead of time so that s/he will know how to help you through it. At the end of this phase, your cervix will be fully dilated and prepared for you to push.

[edit] Stage Two

This is the part of labor when you'll be pushing. It may be no picnic, but it will end with the birth of your baby! The length of this stage will depend on your positioning and several other factors.

[edit] Stage Three

Stage three consists of the expelling of the placenta, which will probably seem like a picnic compared to pushing out the baby! (Placentas are typically much smaller than infants.) Nursing the baby during this stage will help your uterus to contract and expel the placent as well.

Source: http://www.babycenter.com/refcap/177.html

[edit] What about c-sections?

Some women may plan to have a cesarean section, or c-section; other women may have c-sections at their health care providers recommendation because of problems during labor.

According to the Mayo Clinic, "Recovery from a C-section takes longer than recovery from a vaginal birth. Caesarean delivery also carries a higher risk of complications, just as with other types of major surgery." You can read more about the circumstances under which C-sections may be recommended by health care providers and the possible complication of C-sections here.

Source: C-section: When is it the best option? -- MayoClinic.com

[edit] Resources

[edit] LiveJournal communities