Take advantage of our CWC pregnancy guide

Transcription

Pregnancy
and Childbirth with
Complete Women Care
We at Complete Women Care will be happy to be with you and support you
on every step during your pregnancy and childbirth. In this exiting time of
your life you need more than just one dedicated doctor. That is why we will
provide you with an entire team of experienced female doctors, nurses and
a health coach dedicated to helping you having a healthy pregnancy and
childbirth.
Pregnancy
Doctors & Staff of Complete Women Care
and Childbirth with Complete Women Care
Pregnancy is an exciting time in a woman’s life. Being pregnant and
expecting a new addition to your family evokes feelings of happiness and
excitement but also nervousness.
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Contents
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Medical History and Patient Information record
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
Your visits
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Estimated Date of Delivery
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Laboratory Tests
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Fetal Assessment
6
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4D Ultrasound
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Signs and symptoms you should report to us
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Second and third trimester counseling
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Hospital Affiliations
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Nausea
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Sex & Pregnancy
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Traveling
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Exercising
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Alcohol during pregnancy
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Tobacco during pregnancy
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Oral health
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Nutrition, Weight Gain And Weight Los
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Gaining weight
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Losing weight
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Eating for two
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My gain in weight
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Nutrition
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Vitamins and minerals
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Medication
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Pregnancy week by week
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Conception to week 8
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Weeks 9 to 12
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Weeks 12 to 16
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Weeks 16 to 20
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Weeks 20 to 24
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Weeks 24 to 28
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Weeks 28 to 32
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Weeks 32 to 36
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Weeks 36 to 40
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Fetal Movement Count
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Fetal Movement Count Sheet
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Labor Guide
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Contraction Counter
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Caring For Yourself After Giving Birth
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Warning Signs And Common Discomforts Of Pregnancy
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Exercises For Pregnancy And Childbirth
Becoming a dad
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Birth Planner
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What To Expect, What To Do And What To Avoid
Pregnancy
Prenatal Care
prenatal care
Our goal for this wonderful time in your life is to ensure the birth of a healthy baby with
minimal risk to you. We view Prenatal care as a relationship. We want you to ask questions,
bring your loved one to visits, and be at your healthiest for this pregnancy.
During your pregnancy, we strive to:
 MEDICAL HISTORY AND PATIENT INFORMATION RECORD
At or prior to the first prenatal visit, you will complete a questionnaire detailing your social,
medical, and family history.
 YOUR VISITS
Seeing your Doctor
A complete physical examination is usually performed at your first visit, unless one has been
done with our group recently. Baseline blood pressure, weight, and height will be recorded
as part of the examination. Calculating body mass index (BMI) helps to identify at risk
populations and enables counseling of the amount of appropriate weight gain in
pregnancy. You will have your blood drawn and you will have to give a urine sample for
laboratory tests.
The doctor will give you a prescription for iron and vitamins pills. Before you leave, make sure
to schedule your next appointment. We will see you
every four weeks until 28 weeks of gestation, every
two weeks from 28 to 36 weeks, and then weekly
until delivery.More frequent visits may be of benefit
in monitoring women with diabetes, hypertension,
threatened preterm birth, post term pregnancies,
and other pregnancy complications.
If you cannot keep your appointment please call at
least 24 hours before your appointment to cancel
and reschedule a new date and time.
Write down questions for your doctor and nurse
when you think of them and bring them to your next
appointment.
Meeting your Health Coach
Based on Harvard Medical School
recommendations, we hired a health coach for our
pregnant patients. She is a nurse practitioner, who has the latest information from leading
medical institutions about important health topics such as proper nutrition, exercise, and
breastfeeding.
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Establish an accurate Medical History to identify if you are at risk for complications
Determine early, accurate estimation of gestational age
Proceed with ongoing evaluation throughout gestation, including regular visits, blood
work, and ultrasound to evaluate the health status of you and your baby
Anticipate problems and intervene, if possible, to prevent or minimize problems
Create opportunities for your education and communication with our staff
Pregnancy
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She meets with all pregnant patients on a regular basis, and spends about half an hour oneon-one counseling. We encourage you to schedule up three appointments with our Health
Coach during your pregnancy.
ESTIMATED DATE OF DELIVERY
A tentative estimated date of delivery (EDD) can be calculated from the menstrual history
by adding seven days to the first day of the last menstrual period (LMP) and then subtracting
three months (in women with 28 day cycles). As an example, if the last menstrual period is
February 20, then the EDD will be November 27. If the last menstrual period is May 28, the
EDD will be March Accurate dating, however is crucial for managing your pregnancy,
especially with regard to timing interventions and monitoring fetal growth. Therefore we use
Transvaginal Ultrasound on the first visit to estimate the EDD. First trimester ultrasound
examination also can lead to earlier detection of clinically unsuspected fetal malformations
and earlier detection of multiple gestation (twins, triplets, etc)
In the absence of obvious physical findings,
suspected pregnancy will be confirmed by
laboratory evaluation. The standard test in our
office is the detection of the beta-subunit of
human chorionic gonadotropin (hCG) in urine.
This will be collected prior to entering the
examination room.
First trimester laboratory test
A standard panel of laboratory tests are
recommended for every pregnant woman at
Complete Women Care. This panel can be
augmented by additional testing of women at
risk for specific conditions. Repetition of tests
performed by your Primary Care Provider
however will not need to be repeated. The
standard panel typically consists of:
Rhesus type and
antibody screen
Hematocrit or
hemoglobin and
mean corpuscular
volume (MCV)
Rubella
immunity testing
Urine culture
Syphilis testing to
prevent perinatal
transmission
To detect antibodies potentially causing hemolytic disease of the newborn.
Rh(D)negative women should receive anti(D)-immune globulin, as indicated.
To detect anemia and to screen for thalassemia. An MCV <80 fL in the absence
of iron deficiency suggests thalassemia and further testing with hemoglobin
electrophoresis is indicated.
If nonimmune, you will receive postpartum immunization. Once documentation of
immunity to rubella as a result of infection or immunization has been obtained,
repeat testing is unnecessary.
As pregnant women you are at higher risk of developing pyelonephritis (kidney
infection) with untreated asymptomatic bacteria in the urine. You will be treated
with antibiotics if diagnosed.
Hepatitis B antigen testing to prevent perinatal transmission, even if previously
tested or vaccinated
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Pregnancy
 LABORATORY TESTS
ACOG supports universal HIV testing of pregnant women early in each
pregnancy
Will follow current guidelines and are not augmented for pregnancy.
Down syndrome is the most common chromosome abnormality among live born
infants. All our patients are offered Down syndrome screening. While such
screening can be performed in the first or second trimester or both, first trimester
screening test characteristics are better than those in the second trimester only.
Cystic fibrosis
Information about cystic fibrosis screening should be available to all couples.
Cystic fibrosis carrier screening especially should be offered to couples who are at
increased risk because of Caucasian, European, or Ashkenazi Jewish ancestry
Testing for
heritable disorders
The genetic history guides diagnostic testing for heritable disorders
Red cell indices
Hemoglobin
electrophoresis
Tay-Sachs Disease
Fragile X
Thalassemia occurs in higher frequency in the Mediterranean area,
the Middle East, Southeast Asia, Africa, and the Indian subcontinent
The structural hemoglobin variants S and C are most common in tropical Africa,
but are found in the Mediterranean area, Saudi Arabia, and Caribbean.
Hemoglobin E is noted among Southeast Asians and may be the most common
structural hemoglobin disorder in the world.
Patients who are of Eastern European (Ashkenazi) Jewish descent or who have a
relative with one of the genetic conditions prevalent in the Ashkenazi Jewish
population should be offered carrier screening. Tay-Sachs disease also has a
higher prevalence in individuals of Pennsylvania Dutch, Southern Louisiana Cajun,
and Eastern Quebec French Canadian descent.
The population at risk includes, but is not limited to, individuals of either sex with
intellectual disability, developmental delay, or autism.
Second and third trimester laboratory test
Screening for
neural tube
defects and
Down syndrome
Gestational
diabetes
Blood count and
antibody
screening
Group B
streptococcus
testing
All pregnant women will be offered screening for neural tube defects and Down
syndrome (if not already performed in the first trimester).
Universal screening for gestational diabetes is recommended at 24 to 28 weeks of
gestation. You will also be assessed for risk factors to determine if screening should
be done in the first trimester. ie, obesity, prior history of gestational diabetes, prior
macrosomic infant.
A hemoglobin or hematocrit should be repeated early in the third trimester to
assess for anemia. Increased iron and folate requirements of pregnancy may
result in anemia, which can be corrected by appropriate supplementation.
Prevention of anemia may decrease the need for blood transfusion, and
associated risks, if hemorrhage occurs.
You will be screened for group B beta-hemolytic streptococcus (GBS) colonization
with swabs of both the lower vagina and rectum at 35 to 37 weeks of gestation.
The only patients who are excluded from screening are those with GBS bacteriuria
earlier in the current pregnancy or those who gave birth to a previous infant with
invasive GBS disease. These patients will receive prophylactic antibiotics during
labor
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Down syndrome
screening
The Centers for Disease Control (CDC) and ACOG
recommend chlamydia screening for all pregnant women.
Pregnancy
Chlamydia and
Gonorrhea testing
Human
immunodeficiency
virus
Cervical Cancer
Screening
 FETAL ASSESSMENT
Sonographic and cardiographic fetal assessments are indicated in patients atrisk for
fetal complications. We offer Antenatal testing in the office for those at-risk patients
determined during your prenatal course.
 4-D ULTRASOUND
We provide 4-D images for you and your family to enjoy between the 28th-32nd week
of gestation.
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Vaginal bleeding
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Leakage of fluid per vagina
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Uterine contractions
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Decreased fetal activity
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Signs of preterm labor (eg, low, dull backache; increased uterine activity
 SIGNS AND SYMPTOMS YOU SHOULD REPORT TO US
compared to previous patterns; menstrual-like cramps; diarrhea; increased
pelvic pressure; vaginal leaking of clear fluid, spotting, or bleeding)
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Signs or symptoms suggestive of a medical or surgical disorder should be
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reported.
Chills, fever, constant vomiting and diarrhea
We are available 24 hours/day, 7 days a week. If you need to get in touch with a
doctor after hours or weekends, call any of our office numbers to be connected
with the phone service. This person will then page the physician on call.
 SECOND AND THIRD TRIMESTER COUNSELING

Route of delivery
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Management of labor
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Postpartum issues — See Postpartum Care
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Breastfeeding
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Neonatal circumcision
Pregnancy
A number of issues will be discussed in preparation for labor and delivery. These
include, but are not limited to:
 HOSPITAL AFFILIATIONS
Our Doctors deliver out of Long Beach Memorial Medical Center and St. Mary’s
Medical Center Long Beach . Your insurance carrier will determine your preferred
hospital.
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St. Mary Medical Center Long Beach - www.stmarymedicalcenter.org
1050 Linden Ave
Long Beach, CA 90813
Phone: (562) 491-9000
Pregnancy
Long Beach Memorial Medical Center - www.memorialcare.org
2801 Atlantic Avenue
Phone: (562) 933-2000
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what to expect,
what to do and what to
avoid
What can you do:
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Eat small amounts of food
frequently throughout the day. Try a bite or two every half hour
Do not eat large meals on an empty stomach
Try taking your prenatal vitamin before bed.
Helpful tips to settle your stomach
Ginger cookies, ginger ale, or ginger tablets
Peppermint
Cut-up fruit such as cantaloupe or watermelon
Flavored popsicles
Mix equal parts of water and juice. Try 1 tsp every 5 minutes until you can
larger sips.
Melba toast, dry bagel, or dry toast
Vitamin B-6 50mg 2 times a day.
Sea band may help
 SEX & PREGNANCY
Sometimes we are embarrassed to talk about sex and pregnancy and many people
have trouble bringing up questions about sex with their doctor. Worse, women and
men often keep their fears and feelings to themselves.
If this is your first child you may not know that pregnancy may be a time of mood
changes for you and the father of the baby. You may feel tired excited,
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Pregnancy
In the first half of pregnancy, feeling
sick or nauseated is quite common,
as is vomiting. The degree of nausea
and vomiting differs from woman to
woman. Nausea can occur any time,
day or night, lasting minutes, hours, or
all day.
But the good news is it usually
improves by the 2nd trimester.
 NAUSEA
Happy, depressed, hopeful, scared, motherly, and beautiful or uncomfortable and
unattractive. The father on the other hand may feel proud at having fathered a
child or may be anxious about new responsibilities. He may feel protective toward
you or the growing baby or jealous of you r new concentration on the pregnancy.
Sex during pregnancy FAQ
Will My Desire For Sex Be Less During Pregnancy?
No two man feel the same way during pregnancy. For most women pregnancy
does not change their interest in sex. At certain times some women feel like they are
losing their figure and looks during pregnancy. They may feel less desirable and shy
away from lovemaking. Or they want sex more often than usual
As reassurance that their partner sill loves them and finds them attractive.
Can Vigorous (Energetic) Sex Harm The Baby?
It is almost impossible to harm the baby in the uterus by having sex. The water that
the baby floats in, the membranes that hold the water, the womb, the abdominal
wall, and the bony pelvis serve to protect the baby from being hurt.
How often is safe to have sex during pregnancy?
How often you have sex will not affect the baby unless you have high risk problems
and you have been told not to have sex.
Can I have sex any time during pregnancy?
Sex is usually allowed throughout pregnancy until the last few weeks. Some doctors
feel that during the last few weeks’ sex may cause premature rupture of the
membranes. The best is to follow you own doctors’ advice.
Sex should be stopped and you should call our office if:
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Your water leaks or bag of waters breaks
You have vaginal bleeding, itching or discharge
You feel pain in the vagina or abdomen
You have tightening in your uterus, contractions or premature labor
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Pregnancy
The following are some answers to questions about sex during pregnancy. If you
have further questions or if you have a sexual problem during pregnancy that you
cannot solve, remember that our doctors are there for you.
Write down you questions and bring them along to your next appointment. You may
think your question is unique, but other people have probably had the same
concern.
These mood changes may affect how you feel about each other and your desire
for sex. The most important thing is not what you feel, nor how silly you think it is, but
sharing those feelings with each other. In this way you can make necessary changes
for a sexual relationship that continues to be good for both of you.
 EXERCISING
If you have been exercising prior to pregnancy, that's great, continue.
If you haven't been exercising- start slowly, try walking for 10 minutes 5 times a week.
Gradually increase to 40 minutes per day.
Recommended
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Walking
Cycling
Hiking
Pre-natal yoga
Swimming
Low-impact aerobics
Rock climbing
Mountain biking
Snowboarding or skiing
Scuba Diving
Horseback riding
If you find yourself out of breath, decrease the intensity level:
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Work longer, not harder.
40 minutes of walking at a moderate pace is better than 10 minutes of fast
walking if you are out of breath.
Drink plenty of fluids
After your 5th month, avoid exercising on your back, as this decreases blood
flow to you and your baby
Avoid any exercise that could cause you to fall, as your baby grows, your
center of gravity changes.
 TRAVELING
As long as there are no identified complications or concerns with your pregnancy,
it is generally safe to travel at all times during your pregnancy. The ideal time to
travel during pregnancy is the second trimester. In most cases, you are past the
morning sickness of the first trimester and several weeks from the third stage of
pregnancy when you are more easily fatigued. There are some things to consider
that could make your trip safer and more comfortable.
Travel on land
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It is essential to buckle-up every time you ride in a car. Make sure that you use
both the lap and shoulder belts for the best protection of you and your baby.
Keep the air bags turned on. The safety benefits of the air bag outweigh any
potential risk to you and your baby.
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Pregnancy
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Not recommended
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Travel by air
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Most airlines allow pregnant women to travel through their eighth month.
Traveling during the ninth month is usually allowed if there is permission from
your health care provider.
You may want to choose an aisle seat which will allow you to get up more
easily to reach the restroom or just to stretch your legs and back.
Travel on major airlines with pressurized cabins and avoid smaller private
planes. If you must ride in smaller planes, avoid altitudes above 7,000 feet.
Travel by sea
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Check with the cruise line to ensure that there is a health care provider on
board in case there are any complications.
Review the route and port-of-calls to identify if there is access to any medical
facilities if needed.
Make sure any medications for seasickness are approved for women who are
pregnant and that there is no risk to the developing baby.
Seasickness bands use acupressure points to help prevent upset stomach
and may be a good alternative to medication.
 ALCOHOL DURING PREGNANCY
Drinking alcohol during pregnancy can cause both
mental and physical birth defects in babies and may
result in deformities, social or learning problems, and
sometimes death. There is no safe level of alcohol during
pregnancy, and it should be completely avoided. That
includes the time you are trying to conceive, since many
times you may be pregnant before you realize it.
According to recent studies, women who drink alcohol
while trying to conceive, even in small amounts, may
reduce their chances of becoming pregnant. Alcohol-related birth defects are
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Buses tend to have narrow aisles and small
restrooms. This mode of transportation can be
more challenging. The safest thing is to remain
seated while the bus is moving. If you must use
the restroom, make sure to hold on to the rail or
seats to keep your balance.
Trains usually have more room to navigate and
walk. The restrooms are usually small. It is essential
to hold on to rails or seat backs while the train is
moving.
Try to limit the amount of time you are cooped
up in the car, bus, or train. Keep travel time
around five to six hours.
Use rest stops to take short walks and to do stretch to keep the blood
circulating.
Pregnancy
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more likely to result from the intake of alcohol during the first trimester, when the
brain and many of the baby's organs are developing. Growth problems are likely to
result from drinking alcohol in the third trimester. Drinking at any stage of the
pregnancy can affect the brain. Drinking alcohol can also increase the risk of
miscarriage, low birth weight, and stillbirth babies as well as fetal alcohol syndrome.
If you are having a problem with not drinking, you should seek professional help.
“According to the American Lung
Association,
"Smoking
during
pregnancy accounts for an estimated
20 to 30 percent of low birth-weight
babies, up to 14 percent of preterm
deliveries, and some 10 percent of all
infant deaths."
It will not protect your baby if you
merely cut down on your smoking or
switch to lower tar cigarettes. Women must quit smoking while trying to
conceive, while pregnant, and while breastfeeding. This can be the perfect
time to stop smoking for life and help decrease your risk of developing future
tobacco-related health problems, such as cancer and heart disease.
Kicking the habit can take time, so get started well before you begin trying to
conceive.”
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Pregnancy
Cigarette smoking or any other kind of tobacco use can be very hazardous
throughout your pregnancy. Smoking has been proven to cause miscarriages and
pre term delivery, as well as infant death. Smoking can cause low birth weight,
asthma in infants and young children, SIDS, and other respiratory diseases. People
who smoke inhale nicotine and carbon monoxide, both of which can travel through
the placenta directly to the baby. This can prevent the fetus from receiving the
oxygen and the nutrients it needs to grow and develop properly. Secondhand
smoke can be just as hazardous and should be avoided when possible. After
pregnancy, it is important to remember that your breast milk often contains what is
in your body. If you smoke while breastfeeding, your baby can ingest the nicotine in
your milk.
 TOBACCO DURING PREGNANCY
 ORAL HEALTH
It's important for you to take good care of
your teeth and gums while you are
pregnant. Pregnancy causes hormonal
changes that increase your risk of
developing gum disease, which in turn, can
affect the health of your developing baby.
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Nutrition is very important during
pregnancy because your baby gets
nutrients from your system. By eating
right, you can start caring for your
baby’s teeth as soon as you find out you are pregnant. Be sure to include
foods with calcium and vitamin D in your diet. Your doctor can give you
information to help you eat well during pregnancy.
Some women have dental problems during pregnancy. Hormonal changes
can make your gums sore, swollen and bleeding. This can be prevented by
brushing and flossing your teeth daily. If you did not have your teeth cleaned
before you found out that you were pregnant, having your teeth cleaned by
a dental hygienist or dentist early in your pregnancy may help prevent most
gum problems.
Some women develop a “pregnancy tumor” on their gums. This is a painless
bump on your gums that can be pink, red or purple. It will usually not cause
any problems, but care should be taken to keep the area around the tumor
clean. See your dentist if you think you may be having this problem.
Dental problems also can be caused by snacking more often. When the
snacks are sweet, tooth decay or cavities occur. It is important to snack less
often, or eat sweets at the end of a meal instead of between meals.
It is important to see your dentist and dental hygienist during your pregnancy
to prevent dental problems. Be sure to make a dental appointment before
your baby is born. After birth, it may be several months before you will be
able to find the time for an appointment.
If you need to have emergency dental care during your pregnancy, you
may need to have some X-rays taken of your teeth. Always be sure to remind
your dental care professional of your pregnancy. Care should be taken to
limit or avoid nitrous oxide, some prescribed antibiotics and some pain
medications. Your dentist can contact your obstetrician with any questions.
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Pregnancy
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The following facts are true and will help to
improve your dental health during your
pregnancy!
nutrition, weight
gain and weight los
Weight gain is normal during
pregnancy. It is a part of the
body changes that occur. We
strongly recommend to control
your weight gain if you want a
healthy baby. You should control
when your weight is gained and
you also need to control how
much you gain. A slow and
steady weight gain is best.
You should gain about 2 to 4 lbs
the first three months. After that,
you gain about 1 lba week. You
total gain weight should be
about 25 to 35 lbs, if you are
healthy and of normal weight.
 LOSING WEIGHT
It is not good for your baby if you lose weight while you are pregnant. Pregnancy is
not the time to lose weight. You can lose weight after the baby is born. Write down
all questions regarding weight lose and weight gain during pregnancy and bring
them to your next appointment with our doctor or our Health Coach.
 EATING FOR TWO
Pregnancy
Pregnant women only need to add 300 Calories a day to their diet to take care of
the baby. “Eating for two” is an old fashioned idea, which is inaccurate.
 GAINING WEIGHT
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 my gain in weight
Keep record of your weight gain during pregnancy in order to be able to see if your
gains fir the recommended pattern.
Height:
Weight before pregnancy:
Weight on first visit:
present weight
gain in weight
weeks’ gestation
Pregnancy
date
Week’s gestation on first visit:
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 NUTRITION
Balanced nutrition will help you to meet extra demands of pregnancy while keeping
you and your baby healthy. During pregnancy your body needs more calories (add
300 calories daily), protein, vitamins and minerals.
Pregnancy
Take a look at the food guide pyramid for pregnancy.
Eating the daily recommended servings for each food group will help you to ensure
a healthy pregnancy and to keep your weight gain in control.
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Milk yogurt and cheese
Recommended serving per day: 4
Servings:
 1 cup milk
 1 oz cheese
 1 1/3 cup cottage cheese
 1 ½ cups ice cream
 1 cup yogurt or custard
Meat, Poultry, Fish, Dry Beans, Eggs and Nuts
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Eggs
Cheese
Peanut butter
Dried beans, cooked
Recommended servings per day: 2-3 / 6-7 oz total
 Beef
 Chicken
 Fish
 Lamb
 Turkey
 Pork
 Organ meats
1 egg= 1 oz meat
1 slice = 1 oz meat
2Tbsp = 1 oz meat
½ cup = 1 oz meat
Fruits
Recommended servings per day: 3-4
Servings: 1 serving = 1 medium fruit / ½ cup juice
Vegetables
Pregnancy
Recommended servings per day: 1 serving = ½ cup cooked or 1 cup raw
vegetables.
Choose one good source of vitamin C daily. For example:
 Broccoli
 Cabbage
 Cantaloupe
 Grapefruit
 Greens
 Oranges
 Orange Juice
 Strawberries
 Tomatoes
Choose one good source of vitamin A every other day. For example:
Apricots, Spinach , Sweet Potatoes, or Carrots
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Bread, Cereals, Rice and Pasta
Recommended servings per day: 9-11
Servings: 1 serving = ½ cup or 1 slice
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Bagels
Bread
Noodles
Macaroni
Cereals
Rice
Spaghetti
Limit sweets and high fat foods such as soda pop, candy, pastry, cakes,
Cookies and doughnuts. For desert chose fruit or an occasional serving of
frozen yogurt, sherbet, pudding or gelatin. Chose low-fat products.
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Use very little margarine, sour cream, mayonnaise and salad dressing. Try
reduce calorie varieties.
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Avoid fried foods such as French fries. Do not fry meats, fish and chicken.
Bake or broil these foods instead. Remove the skin from chicken, if serving
fried foods, remove the coating.
Pregnancy
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In case you gain weight too fast please try to:
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 VITAMINS AND MINERALS
Take your prenatal vitamins and other food supplement prescribed by your doctor
daily.
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Fish that may contain mercury or other contaminant.
Shark, Swordfish, king mackerel, tuna, and tilefish are all high in mercury. Limit
all fish, including canned tuna, to less than 12 oz each week.
Avoid uncooked fish and or shellfish. Avoid consuming shrimp ceviche and
shrimp cocktail.
Aspirin or NSAIDS (Motrin, Aleve, Ibuprofen, Advil): These may cause bleeding
or complications for the baby.
Herbs such as black/blue cohosh, buckthorn, cascara, ephedra, feverfew,
mandrake, mugwort, sienna, tansy, and yarrow.
Foods that contain bacteria or parasites such as unpasteurized juice, raw
meat, raw fish, and raw shellfish, soft cheeses such as brie, feta, blue, goat,
camembert, gorgonzola, and Mexican soft cheeses.
Deli meats which should be fully warmed prior to eating.
Limit the amount of Caffeine: less than 10oz a day
Try to avoid /artificial sweeteners (try avoiding saccharin)
Wash fruits and vegetables well.
ALSO TRY TO AVOID
Cat litter and soil: These may contain toxoplasmosis, a harmful parasite.
When gardening, wear rubber or leather gloves.
Avoid hot tubs and saunas
Pregnancy
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WHAT TO AVOID
19
 MEDICATION
COUGH
Robitussin 2 teaspoon, 3 times a day if needed
SORE THROAT
Gargle with salt water. Prepare 1 teaspoon of salt to 8 ounces of
warm water. Chloraseptic spray as often as needed.
STUFFY NOSE
For nose congestion you can use a humidifier.
Sudafed 1-2 tablets every 6 hours (after 12 weeks)
HEADACHE
Take Tylenol, 2 tablets, every 4-6 hours.
Do not take more than 6 tablets in 24 hours.
HEARTBURN
You can take Maalox-Plus, Tums or Gaviscon. Start with 1
teaspoon ½ to 1 hour before each meal. If you cannot get relief,
increase to 1 tablespoon before each meal.
CONSTIPATION
Increase fiber in your diet. You can take Metamucil or other fiber
supplements.
Pregnancy
If any of these symptoms cannot be relieved with the medications indicated above,
please contact our office.
We recommend the following medications while you are pregnant:
20
pregnancy week by
week
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Hereditary characteristics were set when the sperm met the egg.
Father’s sperm determined your baby’s sex.
Brain, nervous system, heart, and lungs are forming.
Tiny spots for eyes, ears, and nose exist and arm and leg buds are
formatting.
Baby grows inside a sac of atomic fluid (bag of waters.)
Baby is about ¼ to 1 inch long at the end of week 8
You were two weeks pregnant when you missed your first period, and
six weeks pregnant when your second period was missed.
You may feel nauseated (morning sickness) any time of the day and
tired, your breasts begin to feel tender.
Uterus is growing larger, but you cannot feel it,
You have not gained weight or changed body size.
Make an appointment to start prenatal care.
Check with your doctor or clinic before taking any medicine.
Avoid x-rays while you are pregnant.
Limit drinks that have caffeine (colas, teas, coffee).
Eat balanced meals (take a look at our nutrition suggestions sheet)
Talk with your partner about feelings you both have about this
pregnancy
Decide when and how you will tell your family, friends, and employer
about your pregnancy
Continue to take or start taking prenatal vitamins and folic acid.
21
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TO WEEK 8
Pregnancy
Your responsibility
Your body
Your baby
 CONCEPTION
 WEEKS 9 TO 12
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Your body
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Your responsibility
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You may gain 1 or 2 lbs, your waist and breast size increase, and the
area around your nipples (areola) and your nipples to darken
Your cloths may begin to feel tight around your waist
Uterus may feel like a small lump above your pubic bone. It is softer,
rounded and larger. It crowds the bladder so you may urinate more
often.
Placenta is growing and more hormones are being produced
Tissues around the vagina become bluish as more blood supply
nourishes your baby
Vaginal discharge becomes thicker, whiter and stickier
You may be more tired and have less energy
Nausea (morning sickness) may still occur and it may be more
noticeable in the morning
Begin regular prenatal checkups.
Ask about any drugs you are taking.
Begin prenatal vitamins and iron as prescribed by your doctor.
Exercise by walking, swimming or biking 15 minutes a day.
Enroll in a prenatal class.
Drink six to eight glasses of water each day .
Ask good friends or family about their experiences during the first few
months of pregnancy.
Check if you have insurance for maternity and baby benefits. This
should be done before delivery.
22
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Eyes and ears are in a critical time of growth. Facial features are
forming
The head is large, since the brain grows faster than the other organs.
Cartilage, skin, and muscles are starting to shape your baby’s body.
The umbilical cord has formed
Fingers, toes and fingernails are forming
Stomach, leaver and kidneys are developing
The heart is beating
Baby will weigh about ½ to 1 oz. and be about 21/4 inch long
Pregnancy
Your baby
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Your
responsibility
Your body
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The baby is still to tiny for you to feel movement
Ears, arms, fingers, legs, feet and toes are completely formed
The taste buds are forming
The head can be held up
Reflex movements allow your baby’s elbows to bend. Legs to kick
and fingers to form a fist
The heartbeat is 120 to 160 beats a minute
Blood goes through the cord to the baby
About 1 cup of amniotic fluid surrounds your baby in the sac
Baby’s kidneys circulate the fluid swallowed b the baby back into
the amniotic sac
Baby will weigh about ¼ lbs and is about 21/4 inch long
You will usually begin to feel better by week 16
You generally will be less sick to your stomach and usually will have
more energy
You may have gained a total of about 2-3 lbs
You may begin to feel more hungry
The placenta is formed and hormones are keeping your
pregnancy healthy. You may be able to feel your uterus above
the pubic bone and your uterus may harden from contractions
You may have trouble with constipation
You may sweat more
You may have mood swings such as being happy or sad for no
reason
Get your prenatal checkup. Ask about changes that worry you.
Continue exercising, eating balanced meals and take all
medications prescribed by your doctor.
Check your budget and begin to set some money aside for baby
items.
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Pregnancy
Your baby
23
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Your body
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Your responsibility
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You baby starts a growth spurt in length and weight
Hair begins to grow on the hand and downy hair, called lanugo,
begins to cover the baby’s body. Eyebrows and eyelashes start
to grow.
The skin starts to fill out with fat
The kidneys make urine
Your baby enjoys moving about the amniotic sac. You may feel
baby’s movements to the end of week 20. The amniotic fluid
increases.
This marks the midpoint of your pregnancy
Baby will be about 10 inch long and weigh about ¾ lbs
Your pregnancy is beginning to show
You may gain ¾ to 1 lbs a week (3 to 4 lbs by week 20).
Your nipples, the area around them and the line on your
abdomen will darken.
Your placenta releases hormones that help to often some of your
joints and muscles to make labor and delivery easier.
Your blood supply will increase from 31/2 quarters to 51/2 quarters
by the end of your pregnancy
You may be less tired.
You start enjoying your pregnancy
You may be hungry more often and you may feel cravings for
some foods
The chance to get a urinary infection may increase. Drink six to
eight glasses of water each day.
Your uterus will be just below your navel by the end of week 20.
Talk to your nurse about cravings
Get daily exercise. Work up to walk at least a mile. Learn and
practice Kegel exercises (pelvic floor training) and pelvic rock
exercises.
Lie down and put your feet up at least 30 minutes a day.
Chose comfortable cloths to fit your changing size
Wear seat belt low over your hips.
Pregnancy
Your baby
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24
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You will gain about ¾ lbs a week or a total of 3 to 4 lbs.
Your breasts grow larger and softer and the veins start to show. A
clear white fluid called colostrum may leak from your breasts.
You can feel the uterus at the navel or just above it
Constipation may be a problem until the end of your pregnancy
Your hair may feel thicker and oilier.
Continue your prenatal checkups
Buy well- fitting support bras
Enroll in a childbirth education class for expectant couples. It will
provide you information to prepare you for labor and delivery.
Walk and do Kegel exercises (pelvic floor tightening) and pelvis rock
exercises every day.
Take a time for a rest period every day. Lying on your left side may
be comfortable.

Your baby will begin to move a lot. You will feel the baby’s arms and
legs move. There will be active and quite times.
Skin is protected by a white cheese secretion (vernix saceosa) as the
baby moves in the amniotic fluid. The skin is wrinkled and red and is
filling out with fat.
Eyelids are still closed.
Fingernails are growing.
Baby will be about 12 inches long and weight about 11/2 lbs.
Pregnancy
Your responsibility
Your body
Your baby
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25
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Your body
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Your responsibility
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You will continue to gain about 2 to 4 lbs a month. You may
develop stretch marks on your abdomen, hips and breasts.
The uterus may be felt above the navel.
Tightening and relaxing muscles in your uterus (Braxton Hicks
contractions) are preparing for labor. If you have four or more
contractions in 1 hour call our office.
Appetite id good and nausea is rare, although heartburn may
follow heavy, greasy or spicy meals.
Your sex drive may increase or decrease changing from week to
week.
You feel more involved with the baby growing inside you. You
may think about problems that may occur during your
pregnancy and how they might affect the health and well- being
of your baby. Most women worry about this sometime during their
pregnancy.
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Your baby is big enough to be felt when your abdomen is
examined. The skin is still wrinkled and red. The fingerprints are
forming. The eyes are almost developed, and the eyelids can
open and close.
Baby can kick, cry and hiccup
Noises from the outside may cause the baby to move or become
quiet.
Baby will be about 15 inches long and and weigh about 2 ½ lbs.
Get your prenatal checkup on schedule, even if you feel great.
Take needed rests, lying on your left side.
Start collecting things for the baby’s first weeks. As your nurse for
a layette list.
Talk to your doctor about feeding your baby. Decide if
breastfeeding or bottle feeding is best for your baby and you.
Pregnancy
Your baby
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26
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Your responsibility
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A fine soft hair called lanugo covers the baby.
The brain and nervous system are growing quickly, and the
heartbeat might be heart by another person placing an ear on
your abdomen.
Testicles of boys start to move down into the scrotum
Sleeping and waking times are defined. Kicking and stretching
movements are often noticed.
Your baby may suck a thumb.
Your baby is 16 inches long and weighs about 21/2 to 3 lbs.
You gain weigh faster because this begins baby’s greatest
growth period.
Your uterus is moving closer to your rib cage, and you may notice
kicking against your ribs. Your abdomen can be seen moving as
your baby moves.
You may feel awkward and tire easily. Lightheadedness can
occur when you get up.
Your feet, hands and ankles may swell if it is to hot or you have
been standing for a while.
Your breasts may leak enough to require that you place pads in
your bra.
Get your parental checkup.
Discuss how long you want to continue working.
If you are Rh negative, you will need to get your RhoGAM
injection.
Start prenatal classes right away if you have put them off.
Tour the labor and delivery section of the hospital
Plan for things you will need during the first 6 weeks, like
convenience foods, paper plates, disposable diapers, and /or
diaper service.
Make financial arrangements with the hospital.
Make arrangements for the baby’s care after birth. Plan for
someone to help you at home after birth.
Discuss names for the baby with your partner.
Pregnancy
Your baby
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27
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Your responsibility
Your body
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You baby’s eyes are open
The skin is smooth because fat begins to fill out the wrinkles, and
downy hair gradually disappears.
Your baby is active, with patterns of sleep and wakefulness.
You r baby may settle into the position of birth.
The body is now mature enough to survive if your baby is born
during these weeks.
Your baby is about 18 inches long and weighs about 51/2 lbs.
You may have trouble sitting or lying down for long periods
You may have a problem breathing when the baby pushes
against your lungs. The uterus is now near your rib cage
You can feel parts of the baby trough your abdomen.
You may need to urinate more often, as the baby’s head crowds
your bladder, and your vaginal secretions increase.
You may have hemorrhoids and heartburn.
You may sweat and begin to tire more easily.
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32 TO 36
Have a prenatal checkup every two weeks.
Keep doing your walking and stretching exercises. Practice the
exercises from your childbirth class.
Practice relaxation techniques during Braxton Hicks contractions.
Review what happens in labor and delivery.
Practice daily relaxation and breathing exercises.
Talk about feelings and responsibilities with your partner.
Pregnancy
Your baby
 WEEKS
28
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Your body
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Your responsibility
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The eye color is dark grey. This may change after birth.
The fingernails become complete and may grow long.
The baby settles into a head-down position. The baby may seem
quitter because there is less space t move.
There are periods of sleep and activity.
The baby’s organs are maturing so the baby will be ready to
breathe and grow on his or her own after birth.
About 1 quart of amniotic fluid surrounds the baby.
Baby grows about 21/2 inches (to 20 inches in long) and weights
61/2 -71/2 lbs.
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36 TO 40
You may be tired of being pregnant and ready for delivery. You
tire easily and often feel drowsy.
Your abdomen is getting bigger. It may look lopsided when the
baby moves. Your uterus lowers as the baby drops toward the
birth canal. This is called “lightening”.
Your hand and feet may swell.
You may feel pressure low in your pelvis as the baby settles into
position of birth.
The Braxton Hicks contractions are more frequent. If you have 4 or
more contractions in 1 hour, call our office.
Your sleep may be disturbed as you may need to move and
urinate more often.
Get a prenatal checkup every week until the baby arrives
Eat smaller meals more often
Continue to exercise and practice for childbirth
Limit out-of-area travel
Plan for a birth control method.
Cover your mattress and your chair with plastic in case your “bag
of waters” breaks.
List phone numbers of people to call when labor begins.
Pack your suitcase. Put in cloths and other items to use at the
hospital and what you and your baby will wear home.
Get the baby’s car seat ready
Treat yourself and your partner to something special.
Pregnancy
Your baby
 WEEKS
29
fetal movement count
 WHAT IS FETAL MOVEMENT COUNT?
 HOW TO RECORD THE MOVEMENTS?
Choose a time twice a day to count your baby’s movements. Try to plan your fatal
movement counts at the same time each day. Follow these directions for this simple,
but very important test of your baby’s health.
1. Get into a comfortable position. Lie on your left side to move the weight of
the uterus off the large blood vessels. Oxygen is carried through these blood
vessels to your uterus and to your baby.
2. Use the fetal movement counts record sheet to record the movements.
3. Look at a clock and write down the time you start counting.
4. Each time the baby moves, make a mark on the paper.
5. When the baby has moved 10 times, stop counting.
6. Write down the time of the last 910h) movement on the paper.
7. Write down the length of time it took for your baby to move 10 times. Tell your
nurse.
 WHAT IF THE BABY DOES NOT MOVE OR MOVES ONLY
A LITTLE?
If your baby does not move at least 10 times in 1 hour, call your nurse. There are
other ways to check the baby. For example, the nurse will listen to the baby’s heart
rate. She may ask you to move around, either in bed or out of bed if you are
allowed to get up. If the baby still does not move, she will call your doctor. More
tests will probably be ordered. As your nurse or doctor if you have any further
questions.
30
Pregnancy
You can feel movement as the baby pushes against the
wall of your uterus (womb). You can also feel the baby
move by placing your hands on your abdomen. Sometimes
you can see a ripple or little bump on your abdomen when
the baby changes positions. Some women describe the
movements ad “rolling”, “stretching” or “pushing”. Each
feeling of movement counts as one movement. Write down the number of
movements.
Fetal movement count is the number of times the baby
moves during a given period. Babies do not move
constantly. They may sleep for about 20 minutes and then
wake up and move around. One way to check on your
baby’s health before birth is to count the number of times
he or she moves during a certain period each day.

fetal movement count sheet
write down each time your baby moves while lying on your left side for a period of
30 minutes or 1 hour. please do movement counts two times a day, preferably after
meals. if you notice the movements are less than 10 in a 1-hour period, call your
health care provider immediately.
movement counts
total
time
Pregnancy
date
31

labor guide
This is a guide for you about of true and false labor. If you have of these signs before
36 weeks of pregnancy (9 months), call our office/ your doctor right away.
true labor
false labor
what to do
CONTRACTIONS - Muscles of uterus tighten and relax
Contractions usually
irregular.
Contractions get gradually
closer together.
Contractions do not get
closer together; may stop
after an hour or so.
Contractions may be felt in
your back and lower
abdomen.
Contractions usually not
felt in your back.
Contractions continue or
increase with walking.
Contractions stop with
walking.
There is increasing discomfort.
Discomfort does not
increase.
Your cervix softens, shortens,
and dilates.
Your cervix does not
change.
If you think you are in labor:
 Rest, if possible, on your side.
 Time your contractions with a
watch. If one contraction
starts at 9:10 and the next
starts at 9:16, they are 6
minutes apart.
 Eat or drink only light foods
Contractions occur at regular
intervals, last 30 – 60 seconds.
Come to the hospital when:
 Contractions are at the level
you discussed with your
doctor.
 You have called doctor.
(Usually contractions are 5 to
6 minutes apart)
SHOW - Pink, slightly bloody, or mucous discharge from vagina
Show is present in small to
moderate amount due to
cervical change.
Show is not present.
Tell your doctor if you are having
show with contractions.
 Bag of waters may break
before you feel any
contraction
 Fluid usually continues to
leak, especially during
contraction, which may
become stronger.
Bag of waters does not
break.
 If you think your water has
broken, call your doctor and
come to the hospital
 Do not take a bath or put
anything into your vagina
 Wear a pad, if necessary, until
you arrive at the hospital.
Pregnancy
RUPTURE OF MEMBRANES - A trickle or gush of fluid from the vagina after the sack around the
baby breaks (fluid usually clear, but may be white or green).
Be patient because no two births are alike. An average first labor takes around 2 to 14 hours. It will take
some time for your cervix (opening to the uterus) to thin out (efface). The cervix should open (dilate) to
10 cm before the baby can be delivered vaginally.
10 centimeters
32

contraction counter
Keep track of your contractions with this easy to use chart.
start time
time since last
contraction
:
2
:
:
3
:
:
4
:
:
5
:
:
6
:
:
7
:
:
8
:
:
9
:
:
10
:
:
11
:
:
12
:
:
13
:
:
14
:
:
15
:
:
16
:
:
:
length of contraction
Pregnancy
1
stop time
33
caring for
yourself after
giving birth
Perineal Care
Continue to do perineal care until your bleeding has stopped. Do not
douche or use tampons until you see your health care provider 4 to 6
weeks after delivery.
Hand washing
Wash your hands before and after breast care and perineal care.
Always wash your hands before picking up your baby.
Bathing
You may take showers or tub baths as often as desired. You also may
take a warm or hot sitz bath two or three times daily to relieve the
discomfort from stiches or hemorrhoids.
Sexual
intercourse
It is good practice to wait to have intercourse until after your 4- to 6week checkup. It is possible to become pregnant during the 4-to6-week
period after delivery. Be aware that breastfeeding will not prevent
pregnancy.
Breast care
Wear a well-fitted support bra wheatear you are breastfeeding or bottle
feeding. This will make you more comfortable. Your breast may leak
some fluid. Breast pads, worn inside your bra, may help keep your dry.
Menstruation
If you are breastfeeding, you may not menstruate until after your baby
weans from the breast. If you are bottle feeding, you will usually
menstruate 4 to 5 weeks after delivery.
34
Pregnancy
Activity / Rest
Rest as much as possible for the next two weeks. Try to nap when your
baby is sleeping. Do not refuse offers to help. Limit unnecessary activity
like frequent stair climbing. Ten days after delivery, you may do light
housework. Do not lift items heavier than your baby. Whenever possible
sit down to do work. If you are too active, you may notice an increase in
the amount of vaginal discharge.
It takes at least 6 weeks for your body to return to its nonpregnant state. This
information will help you care for yourself after leaving the hospital.
Eat your normal diet unless your health care provider has given you
other instructions.
Increasing the amount of fruits, vegetables, and whole grains in your
diet will help keep your bowel movements soft. Increasing fluid intake
also will help. If constipation is a problem, call your health care provider.
Incision Care
(C-Section or
Tubal Ligation)
Keep the incision clean and dry. It is normal to have a small amount of
pink, watery drainage, from the incision. If the drainage does not stop,
call your health care
provider. You may shower or bathe daily.
Exercise
Walking is good exercise for you. Brief walks of 5 to 10 minutes around
the house and outside will help restore your body to its normal state.
Maintaining good posture, the Kegel exercises (pelvic floor tightening),
and pelvic tilts are good toning exercises you can do right after leaving
the hospital.
Follow –up visit
with your doctor
Make an appointment with your health care provider within the first
week of leaving the hospital. Your provider may want to see you 4 to 6
weeks after giving birth, Some may want to see you sooner than 4 to 6
weeks. During this checkup, your health care provider will tell you if your
body has healed properly.
Pregnancy
Bowel/Bladder
Diet
35
warning signs and
common discomforts of
pregnancy
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Anny bleeding or spotting
Constant low backache
Bag of waters brakes or leaks
Frequent tightening or “balling
up” of the uterus or womb
Change or increase of vaginal
discharge
Chills, fever, constant vomiting
and diarrhea
Decrease in movements of the
baby
Headaches, blurred vision or
swelling of hands or face
Anything else that seems
wrong
Call our office / your doctor immediately if you
have any of the symptoms listed in first column.
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Eat dry crackers, toast, cereal before getting
up or when feel sick
Eat five or six small meals a day
Drink lots of water between means, but not
during meals
Avoid strong food smells
Avoid greasy or spicy foods
Tender breasts
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Wear a support bra
It may help to wear a bra 24h a day
Leaking Breast
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Wear nursing pads or tissue in your bra
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Fatigue is common in early and late
pregnancy
If advised, try to exercise each day to keep
from getting so tired
Lie down at least once a day
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Nausea
Fatigue
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36
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WHAT TO DO
Pregnancy
SYMPTOM
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Try to keep bowel moments regular
Take short rests with hips lifted on a pillow
Sit on firm chairs or sit with your legs crossed
Practice the Kegel exercises
Hemorrhoids
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Low Backache
 Rest often
 Use good posture
 Move around: do not stand in one place too
long
 Use a footstool for your feet
 Keep your knees higher than your hips
 Wear low-heeled shoes
 Use pelvic rock exercises
Vaginal Discharge
 Bathe the outer vaginal area often
 Use soap without perfume
 Do not use vaginal sprays, powders, or feminine
hygiene products
 Do not use colored or perfumed toilet paper
 Wear cotton panties
 Avoid pantyhose, girdles or tight pants
If these hints do not help, talk to your doctor about
the problem.
Heartburn
Dizziness
Varicose Veins
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Stay away from greasy and spicy food
Eat smaller meals , but eat more often
Do not lie down just after eating
Elevate the head of the bed (with pillows) while
sleeping
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Change your position slowly
Get up slowly after you have been lying down
Eat regular meals/drink plenty of liquids
Do not stay in the sun
Report any dizziness to your doctor
 Avoid stockings or girdles with elastic bands
 You may use support hose
 Put support hose on while lying down
37
Constipation
Eat raw fruits, vegetable, prunes and whole
grain or bran cereals
Exercise helps, walking is very good
Never hold back a bowel moment
Drink at least 2 quarts of fluid each day
A cup of hot water three times a day may help
Pregnancy

Increased Secretions
(Mucos-nose/throat/mouth)
 Take care of these problems as best you can
 Do not use over the counter medicine
 Report to your doctor
Trouble sleeping
 Do not eat just before sleep
 To help you relax, try drinking milk
 Take a warm bath before you go to bed or
practice relaxation exercises.
Feel faint when lying on back
 Lie on your left side
Feet and Hands Swelling
 Lie on you r left side for 30 minutes, three to four
times a day
 Exercise often
 Drink more fluid
 Eat three servings of protein each day
 If you wake up in the morning with swelling, tell
your doctor
Bleeding Gums
 Use a soft toothbrush and brush gently
 Drink more orange juice and eat more foods
high in vitamin C
False labor
 Change your position and activity, if it is true
labor it will not stop
 True labor contractions will become more
regular and closer together
 You usually will feel true contractions more in
your back
38
Lower leg Cramp
 Elevate legs often during day
 Point toes upward and press down to kneecap
 Apply a heating pad or hot water bottle for
relief
 Avoid heavy meals at bedtime.
Pregnancy
Shooting Pains down Legs
 Take short rests with legs raised
 Raise your legs when you sit down: do not cross
your legs.
 Change positions: If you are sitting, stand up: if
you are standing, sit down
exercises for pregnancy
and childbirth
 KEGEL EXERCISES
How To Do Kegel Exercises?
1. Locate these muscles, stop and start
to your urine when you use the toilet
2. Try to tighten the muscles a small
amount at a time, thinking of an
elevator going up to the 10th floor, then release very slowly, one floor at a
time.
3. As you tighten the muscles, you should feel the area from your urethra, where
urine exits the body, to the rectum lift slightly.
When To Practice?
Practice while you sit, stand, walk, drive or watch TV
Do these exercise 3 times each day. Start with5 repetitions and work up to 1015 repetitions, 5 – 10 times a day.
Pregnancy


Kegel exercises strengthen the muscles
around the vagina, urethra and rectum. Your
ability to control these muscles will be
increased if you practice these exercises.
39
 KNEE PRESS
The knee press strengthens and stretches your inner thighs and stretches your lower
back. It also improves your circulation.
How To Do The Knee Press?
When To Practice?
1. As often as possible during the day, sit cross legged on the floor with your
back rounded and relaxed.
2. You could do this as a break during TV commercials.
3. Work up to doing 2-3 repetitions., 2-3 times a day.
 ABDOMINAL STRENGTHENERS
Abdominal strengtheners will strengthen and stretch your abdominal (tummy)
muscles and improve your circulation.
How To Do The Abdominal Strengtheners Exercises?
Leg Raise
1. Lie on your back with feet flat on the floor.
2. Bring one knee up to your chest as close as you can.
3. Raise your leg in the air.
4. Bend your knee and return your foot to the floor.
5. Do the same exercise with your other leg.
Pregnancy
Knee Reach
1. Lie on your back with feet flat on the floor.
2. Lift your head and at the same time move one
knee towards your nose.
3. Do the same thing with your other leg.
1. Sit on the floor.
2. Now pull your feet together with soles touching.
3. Bring your feet as near to your body as you can with comfort.
4. Keep your back straight.
5. Press your knees slowly and gently to the floor.
6. Hold your knees to the floor and count to three
When To Practice
Repeat both exercises 5-10 times each day.
40
 THE PELVIC ROCK
The pelvic rock will strengthen your abdominal muscles, relieve backaches and
improve your circulation.
Position One
1. Get on your hands and knees with arms straight.
2. Tighten your tummy muscles and tuck your hips under. Your back will hunch a
little.
3. Relax.
4. Do this slowly and evenly.
Position Two
1. Stand with your back against a wall.
2. Tighten your tummy muscles and tuck in your buttocks so the small of your
back is flat against the wall.
3. If you put your hands on your hip bones, you should feel your hips rock.
Pregnancy
Position Three
1. Lie on your back with your feet flat on the floor.
2. Tighten your lower tummy muscles and your buttocks to press the small of
your back onto the floor.
3. Relax.
4. Repeat slowly and evenly
How To Do The Pelvic Rock ?
This exercise is done in three different positions. Each time you do the exercise,
tighten your abdominal muscles and tuck your buttocks under so that the small of
your back is pushed back as far as possible.
41
becoming a dad
You are about to experience the birth of your child. This is a great time to change
for both you and your partner. Here are some ideas to help you.
YOUR PARTNER’S PREGNANCY
Help her eat right and stay in shape
 She will need to follow a balanced food plan
 This may mean changing some of your own eating habits
 Some exercises is good for both, mother and baby. Encourage her to
exercise
 Try walking with her when you can. Use this time to relax and talk about
pregnancy.
It is important that your partner stays away from alcohol, aigarettes and drugs while
she is pregnant
 Now it is a good time to teach others that second-hand smoke will not be
allowed around the baby.
YOUR CHANGING ROLE





Later in the pregnancy you will need to continue to help your partner.
Help her with housework, cooking and cleaning
Make sure she gets a chance each day to put her feet up and relax
Decide now who will do what after the baby comes home
You are both in this pregnancy together. Plan to share both the work and the
fun.
42
Pregnancy
Your partner should get good
prenatal care
 She should see a doctor on a
regular basis.
 Visits to the doctor can help
make sure pregnancy is going
well.
 You should keep informed
about her pregnancy and ask
questions.
The pregnancy will have more
meaning for both of you if you stay
involved during the entire pregnancy.
YOUR RELATIONSHIP





There will be changes between you and your partner
For instance, you both may have mood swings
You may feel sad, worried, or nervous for no real reason
Try to listen to and help each other. Take the time to talk things over. Your sex
life may also change
It is safe to have intercourse throughout the pregnancy if your partner doesn’t
have complications and remains comfortable. Ask your doctor for additional
advice.





If you have questions during the pregnancy or after your baby arrives, try the
following:
Tlak with family and friends
Ask questions
Read about pregnancy and apretneting skills
Take childbirth classes
Keep a good attitude
Pregnancy
By keeping informed, being patient, and having a good sense of humor, uyou will
be on your way to being a good father.
SOURCE OF HELP
43
Complete Women Care Offices
LAKEWOOD OFFICE
3650 E. South Street, Suite 403
Lakewood, CA 90712
Call: (562) 634-8812
Fax: (562) 634-6033
LONG BEACH OFFICE
2840 Long Beach Blvd, Suite 330
Call: (562) 424-8422
Fax : (562) 424-8770
SAN PEDRO OFFICE
1360 West 6th Street, Suite 165
San Pedro, CA 90731
Call: (310) 832-2369
Fax: (310) 832-1800
Pregnancy
NAPLES ISLAND OFFICE
5865 Naples Plaza
Call: (562) 343-2814
Fax: (562) 343-2817
44
Birth Planner
Writing a birth plan gives you a chance to think about and discuss with your partner
and your caregiver how — ideally — you'd like your baby's birth to be handled. You
can't control every aspect of labor and delivery, but a printed document gives you
a place to make your wishes clear. Just remember that you'll need to stay flexible in
case something comes up that requires your birth team to depart from your plan.
A written birth plan also helps refresh your practitioner's memory when you're in
labor. And it informs new members of our medical team — such as your labor-anddelivery nurse — about your preferences when you're in active labor (and probably
not in the mood for drawn-out conversation).
Doctors & Staff of Complete Women Care
Pregnancy
 Please bring a copy of the birth plan to your next doctor’s visit.
Complete Women Care
45
 my birth plan
Name:
 ATTENDANTS
 AMENITIES
I would like to:
Bring music
Dime the lights
Wear my own cloths during labor and delivery
Take pictures and/or video during labor and delivery
 HOSPITAL ADMISSION & PROCEDURE
I would like the option of returning home if I am not in active labor
Once I am admitted, I would like to:
My partner to be allowed to stay with me all the times
Only my practitioner, nurse, and guests to be present (i.e. No residents, medical students
or other hospital personnel)
To wear my contact lenses, as long as I don’t need a C-section)
To eat if I wish to
To try to stay hydrated by drinking clear fluids instead of having an IV
To have a heparin or saline lock
To walk and move around as I choose
 OTHER INTERVENTIONS
As long as the baby and I doing fine, I would like to:
Have intermittent rather than continuous electronic fetal monitoring
Be allowed to progress free of stringent time limits and have my labor augmented only if
necessary
46
Pregnancy
Partner:
Friend/s:
Relative/s:
Doula:
Children:
I would like the following people to be present during labor and/or birth:
 LABOR PROPS
If available, I would like to try a:
Birthing stool
Birthing chair
Squatting bar
Birthing pool/tub
I would like to bring the following equipment with me:
Birthing stool
Beanbag chair
Birthing pool/tub
Other:
 PAIN RELIEF
I would like to try the following pain – management techniques:
Acupressure
Bath/ shower
Breathing techniques/distraction
Hot/cold therapy
Self – hypnosis
Massage
Medication
Other:
Please do not offer me pain medication. I will request it if I need it.
If I decide I want medicinal pain relief, I would prefer:
Regional analgesia (an epidural and/ or spinal block)
Systemic medication
 PUSHING
Pregnancy
When it is time to push, I would like to:
Do so instinctively
Be coached on when to push and for how long
Be allowed to progress free of stringent time limits as long as my baby and I are doing
fine
I would like to try the following positions for pushing (and birth)
47
Semi-reclining
Side-lying position
Squatting
Hands and knees
Whatever feels right at that time
 VAGINAL BIRTH
During delivery, I would like to:
To view the birth using a mirror
To touch my baby’s head as it crows
The room to be as quiet as possible
To give birth without an episiotomy
My partner to help “catch” our baby
After birth, I would like to:
To hold my baby right away, putting off any procedures that are urgent
To breastfeed as soon as possible
Not to get oxytocin (Pitocin) after I deliver the placenta unless it’s necessary
To wait until the umbilical cord stops pulsating before it’s clamped and cut
My partner to cut the umbilical cord
 C-SECTION
If I have a C-Section, I would like to:
My partner present at all times during the operation
The screen lowered a little bit so I can see my baby being delivered
The baby to be given to my partner as soon as he is dried, if appropriate
To breastfeed my baby in the recovery room
 CORD BLOOD BANKING
I am planning to:
Donate cord blood to a public bank
Bank cord blood privately
Neither
 POSTPARTUM
Pregnancy
After delivery, I would like to:
All newborn procedures to take place in my presence
My partner to stay with the baby at all times If I cannot be there
To stay in a private room
To have a cot provided for my partner
I would like:
24-hour rooming-in with my baby
My baby to room –in with me only when I am awake
My baby brought to me for feedings only
To make my decision later depending on how I am feeling
48
My other children brought in to see me and meet the new baby as soon as possible
after the birth
 FEEDING ISSUES
I plan to:
Breastfeed exclusively
Combine breastfeeding and formula-feeding
Formula-feed exclusively
Do not offer my baby:
Formula
Sugar water
A pacifier
 CIRCUMSTATION
If my baby is a boy:
I want him to be circumcised at the hospital
I will have him circumcised later
I do not want him circumcised
 DISCHARGE
I would like to:
Pregnancy
Be discharged from the hospital with my baby as soon as possible
Stay at the hospital as long as possible
Wait and see how I feel before deciding about the timing of hospital discharge
49

Take advantage of our CWC pregnancy guide

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