Pregnancy Guide Henderson&Walton Women's Center Congratulations

Pregnancy Guide
Henderson&Walton Women's Center
Congratulations
We are pleased that you have chosen us to be a part of this very special time in
your life. Through this booklet, we want to provide you with some helpful
information about your prenatal care and your baby.
Our top priority is to give our patients the highest quality obstetrical care by
competent, compassionate, and caring physicians. The information in this
booklet is intended for patient education purposes only. Based upon your
individual needs, the attending physician may change, add, or delete any
procedures listed in this booklet.
We hope this pregnancy guide will aid in your understanding and enjoyment of
your prenatal care. We look forward to spending the next few months with you!
INDEX
SECTION 1 First Trimester * Conception through week 12
SECTION 2 Second Trimester * Weeks 13 through 27
SECTION 3 Third Trimester * Weeks 28 through 40
SECTION 4 Postpartum
SECTION 5 Your Baby
SECTION 6 Common Questions
SECTION 7 Special Test Information
SECTION 8 Glossary
FIRST TRIMESTER
Conception through week 12
YOUR DOCTOR & WHAT WILL BE DONE
By now, you have discovered that you are pregnant and have had your first
visit with the doctor. During the first trimester, you will probably make two
visits to the doctor. Remember, your care will depend on your needs and the
needs of your baby. Therefore, don’t be surprised if your physician does not
perform every procedure mentioned here or requests something that is not
included. The list below highlights what probably occurred during your first
visit.
INITIAL VISIT WILL INCLUDE
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Interview with a member of our clinical staff to update medical history
Weight check
Complete physical by the doctor, including Pap smear
Blood work
Urinalysis
Prescription of prenatal vitamins and iron supplements
We encourage you to meet with each MD throughout your pregnancy
It was recommended that you contact your hospital or certified childbirth
instructor to schedule prenatal classes.
You were instructed on how to schedule future appointments.
You were given hospital preadmission forms.
Discuss any exercise habits or exercise plans with your doctor
Tests for cystic fibrosis can be done if you request it.
10-14 weeks Visit
PHYSICAL EXAMINATION & TESTING
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Interview with clinical staff
Weight check
Blood Pressure check
Urinalysis
Possible iron level check (if level was low on previous visit)
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Fetal heartbeat check (It is not always heard in the beginning weeks)
Assessment of the accuracy of the baby’s due date
Just a reminder: be sure to take your prescribed prenatal vitamins and/or
iron supplements
SECOND VISIT WILL INCLUDE:
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The doctor will discuss your prenatal lab work including rubella, blood
type, and Rhogam.
If necessary, the nurse will schedule your amniocentesis and genetic
counseling. See chapter 7
If you elect to have the AFP-Triple Screen test performed, it should be
scheduled now for your visit at 16 weeks. (See pg. 39).
The receptionist will assist you in scheduling your future visits. You will
need to schedule a visit once every four weeks, unless advised
differently by your doctor.
YOUR BABY:
4-6 Weeks
Your baby is now a small, almost tadpole-like, embryo. In the next few weeks,
vital organs will begin to develop, which will include the spine, heart, digestive
tract, and arm and leg buds.
6-10 Weeks
Your baby will weigh approximately one third ounce and grow to about one
and one fourth inches. The heart will be beating and the arms and legs will
grow and begin developing fingers and toes.
8-12 Weeks
By the end of this month, your baby will be about two and a half to three inches
long and weigh about a half an ounce. Amniotic fluid cushions the fetus
allowing the baby to move easily. Your baby is able to open and shut its mouth
and turn its head, as well as make a fist and kick. More organs are beginning to
develop, including the reproductive organs, however, it is difficult to
distinguish the gender at this point.
YOUR BODY:
You will begin to see many changes in your body during your pregnancy, as
well as changes in your mood. Your breasts may become very tender and full,
you may need to urinate frequently, you may experience nausea, heartburn and
indigestion, and you will more than likely be fatigued much of the time. These
symptoms are all part of the changes your body is undergoing to manufacture
your baby’s life-support system. It is important that you pay attention to your
body and eat right, get plenty of rest, and don’t feel guilty about being tired!
Here are some specific symptoms you may be experiencing and tips for
handling them:
MORNING SICKNESS:
Many women experience nausea and/or vomiting during the first trimester of
their pregnancy – and morning sickness doesn’t always confine itself to the
morning. There really isn’t a cure for it, but here are several ways to minimize
the effects:
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Ask your doctor about B-6 to reduce nausea
If you are experiencing vomiting with nausea it is important to drink
plenty of fluids to replace the fluids you lose through vomiting. You
might find fluids are easier to get down than solids, and they can provide
vital nutrients .
Try to eat several small meals or snacks throughout the day before you
get hungry. This will keep your system from triggering nausea because
of an empty stomach.
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Take your time getting out of bed in the morning. Have a high
carbohydrate snack in bed before you get up such as crackers, toast, or a
bagel. Also, try to get plenty of sleep and relaxation – fatigue can
increase your morning sickness. Save your liquids until you’re finished
eating to help with nausea
Try not to be around foods that make you queasy. Don’t go to a fast food
restaurant if the smell of greasy food makes you feel bad.
Eat right! A diet that is high in protein and complex carbohydrates will
help fight nausea. Ask your physician about over-the-counter
medications like Emetrol and Emechek
CONSTIPATION CONCERNS:
Constipation can sometimes pose a problem during pregnancy, which makes it
difficult for bowel movements to occur on a regular basis; however, it can be
prevented and corrected by using the following guidelines:
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Drink at least eight eight-ounce glasses of water each day (24-hour
period).
Include liberal amounts of whole-grain breads in your diet. Also, include
a daily serving of cereal that contains four or more grams of fiber per
serving.
Eat several servings of raw vegetables and fruits daily (including dried
fruits).
Establish a regular bowel habit at about the same time each day. Don’t
strain or try to sit for long periods of time on the toilet.
Include a regular exercise program such as walking or swimming, but
always consult your physician first.
NUTRITION:
During pregnancy, it is important to eat a balanced diet. Nutritional support for
you and your baby is best achieved by selecting foods from the food guide
pyramid. Snack foods should also come from these groups, rather than from the
“empty calories” found in high-fat or high-sugar foods such as candy, desserts,
chips, juices and sweetened beverages. The following sample daily food plan
illustrates a balanced approach to eating. You should choose from each food
group for every meal so that the total number of servings per day is as indicated
on the following page.
IMPORTANT POINTS TO REMEMBER
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Eat a variety of foods from each food group.
Eat whole-grain breads and cereals.
Eat raw vegetables and fruits daily.
Drink at least six to eight glasses of waterdaily.
Instead of coffee, tea, and carbonated beverages, drink milk, juice, and
water to decrease your caffeine intake.
FOOD GUIDE PYRAMID
Adapted for Pregnant and Breastfeeding Women
Sample Diet for Pregnant Women
Option 1
Option 2
Breakfast
Egg
Toast, 2 slices or cereal
Fruit or juice
2% Milk
Breakfast
Bran cereal
Toast, 2 slices
Fruit or juice
2% Milk
Snack
Low-fat crackers and cheese
Lunch
Lunch
Low-fat meat and cheese sandwich (with
Lettuce and tomato or a side salad)
Fresh fruit
2% Milk
Salad (with low-fat cheese, meat, and egg on a
bed of vegetables with low-fat dressing)
Fresh fruit
Crackers
Snack
Cottage cheese with fruit
Dinner
Dinner
Lean meat, fish, or poultry
Starchy vegetable (fat-free)
Green vegetable (fat-free)
Bread
Fresh or canned fruit
2% Milk
Homemade soup or stew
Bread or crackers
Fresh fruit
2% Milk
Snack
2% Milk with cereal or graham
Remember:
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Check fat on packaged snacks
Use correct serving sizes
Drink at least 2-3 quarts per day for adequate hydration (and milk
production for the breastfeeding woman). Emphasize water.
Limit added fat to 1 serving per meal. (Check the Nutrition Facts label to
determine the serving size.)
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DO NOT omit fat in your diet. Your body cannot produce essential fatty
acids. You must eat at least 1 serving of fat at each meal to provide these
nutrients
GAINING WEIGHT DURING PREGNANCY:
You should expect to gain between 22 and 30 pounds while you’re pregnant. It
should be gained gradually, about two to four pounds during the first 12 weeks
and about two to three pounds per month thereafter with the majority gained
during the last six months. Even if you are overweight, the extra weight you
will gain is necessary to nourish the baby. This is not a time to lose weight. The
baby will account for about one-fourth of your total weight gain. For example,
if you gain 25 pounds, this is how the weight will be distributed.
Baby…………. 7 ½ lbs
Placenta…………. 1 ½ lbs
Uterus (womb)….. 2 lbs
Amniotic fluid…….. 2 lbs
Breasts…………… 1 lb
Blood volume……… 3 lbs
Tissue and fluid…. 3 lbs
Maternal reserves….. 5 lbs
Total………………25 lbs
WORKING MOTHERS-TO-BE:
If you decide to work throughout your pregnancy, be sure to take breaks often.
Try not to stand or sit for long periods of time. And when you get home, lie
down for an hour or so before you begin cooking or cleaning. Try to share
chores with your partner, and above all, get plenty of rest.
TRAVELING:
When traveling by vehicle, be sure to make frequent stops so you can stretch
and walk around. There may be some airlines that will not allow you to fly after
your seventh or eighth month without a letter or permission from your doctor.
Consult with your doctor before traveling more than one hour away from the
hospital after 34 weeks.
BUCKLE UP. IT’S THE LAW!
You are not only looking after your own safety, but also after the safety of your
unborn child. Wear both the lap belt and shoulder harness no matter how
uncomfortable they can be, and secure the lap belt below your abdomen.
Wearing your seatbelt is not only required by the law, it greatly reduces the
chances of injury to you and your baby if you are in an accident. Be sure to call
your doctor if you are involved in a motor vehicle accident, no matter how
minor.
WARNING SIGNS (Call us if any of the following signs
occur!)
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Any type of vaginal bleeding.
A headache that does not go away and is accompanied by stomach pain
or blurred vision.
Abdominal pain that lasts more than 4 hours.
Continuing intermittent abdominal tightening (contractions or
cramping).
Leaking or gushing fluid from the vagina.
Sudden puffiness or swelling of the hands, feet, or face.
Pain or burning sensation when urinating.
Fever over 100 ºF (38 ºC).
PREGNANCY HAZARDS
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DON’T SMOKE!
Women who smoke during pregnancy often have premature and low-birthweight babies and have twice the risk of placental abruption (miscarriage).
Children who live in smoke-filled households have four times the number of
colds as children in non-smoking households. There is also an increased risk of
sudden infant death syndrome (SIDS) in smoking households.
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HAVE YOUR PARTNER CHANGE THE CAT LITTER:
Toxoplasmosis is an infection humans can acquire from cat feces. There are no
visible symptoms, but it can cause eye and brain defects in the unborn baby.
Have your partner change the litter. But, petting and holding your pet is
acceptable. Also, remember to wear gloves while gardening because of possible
soil contamination from cat feces.
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DON’T DO DRUGS!
Even in small amounts, street drugs are very dangerous. Marijuana use can
result in complications during labor and cause low birth weight. Cocaine or
crack can cause miscarriages, premature births, placental abruption, and brain
damage to the baby. The baby can be born addicted to these drugs and have to
go through a withdrawal process that could be fatal.
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MOTHERS CAN PASS AIDS TO THEIR BABIES!
Women most frequently acquire AIDS from an infected partner or by sharing
needles during intravenous drug use. About half of the babies whose mothers
have the AIDS virus will become infected. If treated during pregnancy, the risk
of infecting the baby can be reduced significantly.
SECOND TRIMESTER
Weeks 13 through 27
14-16 WEEKS Visit
PHYSICAL EXAMINATION AND TESTING
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Interview with clinical staff
Weight and blood pressure check
Urinalysis
Fetal heartbeat
Possible iron level check
Possible alpha-fetoprotein (AFP) performed (Chapter 7).
Amniocentesis and genetic counseling, if previously scheduled
Keep in mind that a physician’s exam or ultrasound may result in a
change of this date. Your baby’s birth will be considered “on time” if it
arrives within two weeks before this date or two weeks after. The
management of labor outside this time frame will be made on an
individual basis.
THIRD VISIT WILL INCLUDE
The doctor will advise you to schedule an ultrasound between the 18 th and 22
nd week. This is a good time to speak with your doctor about symptoms you’ve
been experiencing, especially unusual ones.
17-22 WEEKS Visit
PHYSICAL EXAMINATION & TESTING
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Interview with clinical staff
Weight and blood pressure check
Urinalysis
Fetal heartbeat
Ultrasound
Possible iron level check
FOURTH VISIT WILL INCLUDE:
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The doctor will finalize your approximate due date and discuss
ultrasound results, if applicable. The ultrasound is not a more accurate
due date unless it varies by more than ten days from your LMP (last
menstrual period) due date.
The doctor will discuss your alpha-fetoprotein (AFP) results, if
applicable.
The doctor will discuss your amniocentesis results, if applicable.
Most hospital preadmission forms should be completed and mailed by
this visit.
23-27 WEEKS VISIT
PHYSICAL EXAMINATION & TESTING
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Interview with clinical staff
Weight and blood pressure check
Urinalysis
Fetal heartbeat
Possible iron level check
FIFTH VISIT WILL INCLUDE:
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The doctor will ask you to schedule a glucose screening.
If you have RH negative blood, you will have an antibody screen and
you will get a Rhogam injection in the 28 th week of pregnancy.
YOUR BABY:
16-20 WEEKS
The baby now weighs between four and six ounces and is four to five inches
long with the head making up about one-third of its length. Your baby will
grow very rapidly during this month, and the gender can probably be
determined by this point. The eyelashes and fingernails have begun to grow,
but the toenails have not. And, even though the vocal cords have formed, the
baby is unable to cry yet. The baby’s nourishment is provided by the placenta.
The baby has begun swallowing amniotic fluid and is now urinating and
forming meconium, the stool, in its intestines. The tongue is also working, so
the baby can begin gentle sucking.
20-24 WEEKS
Your baby now weighs between eight ounces and a pound and is eight to 12
inches long – still small enough to hold in the palm of your hand. The head,
trunk, and limbs are now properly proportioned in size. Toenails, eyebrows,
and hair are beginning to grow, and teeth are forming under the gums. There is
fine, soft hair now covering the body called lanugo, and a creamy, white
covering over the skin called vernix. During this month, you will begin feeling
the baby move, but you could mistake it for gas bubbles. Your baby is able to
kick and turn over by now, and your everyday activity gently rocks the baby in
the amniotic sac.
24-28 WEEKS
By now your baby weighs about one and one half pounds and is between 12
and 14 inches long. There is a little body fat, and the skin is still thin, but the
baby could survive with intensive care if born near the end of this month. The
eyelids are beginning to part, and your baby can open its eyes. Because it is
swallowing some amniotic fluid, you could feel rhythmic jerks or jolts when it
hiccups. Your baby’s unique fingers and toes are now visible. You may begin
to recognize your baby’s pattern of activity and rest during the sixth month. It
is different for every baby, but most will kick or turn at least 10 times in a 12hour period.
YOUR BODY:
As you and your baby continue to grow, your uterus will expand and your
abdomen will stretch. You may start to notice reddish streaks on your abdomen,
breasts, buttocks and thighs, which will fade to fine silvery lines after birth.
Oils, creams, and lotions may relieve the itchy, dry feelings as your skin
stretches, but they will not make these lines disappear. Also, because of
increased hormones, a dark line may form from your pubic bone to your navel
called the linea nigra. This is more likely to occur in women with dark hair and
skin. It will become lighter after birth.
Some women experience another result of increased hormones, which are
brown patches appearing on the nose, forehead, neck and cheeks. This is a
natural change during pregnancy. They will begin to lighten and may disappear
after birth.
You may begin experiencing a yellowish fluid leaking from your nipples. This
is colostrum or “the first breast milk.” It is high in protein and low in fat, which
is exactly what the baby will need. It will continue to ooze throughout your
pregnancy, but do not squeeze it from your nipples. Because you will have an
increased amount of blood in your body, you might notice that you have
unusually red palms or tiny red spots on your face, neck, upper chest or arms.
These are tiny groups of blood vessels on the surface of the skin.
ROUND LIGAMENT PAIN:
As early as 18-20 weeks, you might experience some pain in your lower
abdomen or groin. This is because of stretching of the round ligaments, which
are tissues attached to the uterus that hold it in place. They stretch as the uterus
expands. After long periods of sitting, you may experience discomfort upon
standing. Some relief measures you can take are:
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Stand up slowly to allow the ligaments to stretch gradually.
Soak in a warm bath.
Lie on the painful side with your hips turned and place a pillow between
your knees.
Do the pelvic tilt exercise (see pg.16).
Tylenol may be taken to relive pain
Heating pad on a low setting
BRAXTON HICKS CONTRACTIONS:
Throughout your pregnancy, you may experience uterine contractions or “false
labor.” They do not mean the baby is coming. The contractions simply help
circulate blood throughout the uterus and prepare the uterine muscles for labor.
While the pain is mild, it can still be very annoying. The pain might ease if you
increase or decrease your activity. Also, a warm bath, Tylenol, rest, and
drinking plenty of fluids often makes them stop, but, if you have six or more in
an hour that do not go away, call your doctor.
RESTING OR SLEEPING:
You may find the best position for rest is on your left side. This allows for the
best flow of blood to you and your baby. When you lie on your back, the uterus
presses on the large abdominal vein and this can lower your blood pressure and
cause you to become light-headed.
WAYS TO REDUCE SWELLING (EDEMA):
Swelling is common in pregnancy, especially in the hands and feet. Usually a
good night’s rest, while lying on your left side, will help reduce the swelling.
Other recommendations to avoid swelling:
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Restrict the amount of salty food in your diet, but do not eliminate your
salt intake entirely. You need some salt to keep a normal fluid balance.
Whenever possible, elevate your feet for periods of 20 to 30 minutes,
several times a day.
Avoid standing for long periods of time.
Try sleeping with your feet slightly higher than your heart. Raise the foot
of your bed on two to three inch blocks.
Wear support stockings.
Remove your rings before they get too tight.
Lie on your left side when you sleep or rest. This allows for maximum
flow of blood and nutrients to the fetus and more efficient kidney
function for you, providing a better means for the elimination of fluids,
thus reducing swelling.
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Walking helps the muscles in your legs move the fluid out of your legs.
NAGGING BACKACHES:
To help ease nagging backaches:
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Squat, rather than bend, to lift objects.
Wear low-heeled, support shoes.
Try sitting cross-legged.
Always roll to your side before sitting up from a lying position.
Apply either heat or cold to your back.
Ask your partner or a friend to give you a back rub.
Place a board under your mattress to create a firmer sleeping surface that
will support your back.
Wear an obstetric girdle, also called a maternity belt. You can find them
in department stores and maternity shops.
DIET AND EXERCISE AID IN DIGESTION:
During pregnancy, both the baby and the uterus press on your intestines
slowing the movement of food and causing gas. Hormones during pregnancy
cause the digestive tract to relax and work more slowly causing constipation.
Here are some tips to help you ease this uncomfortable situation:
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Set up regular times for both bowel movements and exercise.
Chew your food slowly to avoid swallowing air, and thus prevent gas
from forming in the intestines.
Avoid gas-forming foods such as cabbage, beans, and fried foods.
Drink more water and juice.
Drink decaffeinated tea or hot lemon water first thing in the morning to
ease constipation.
Avoid the use of straws. They cause constipation and gas to form in the
intestines .
HEARTBURN RELIEF:
Many women get heartburn throughout their pregnancy. Here are a few tips on
how to avoid it:
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Avoid eating too much at one time. Try six small meals instead of three
large meals.
Avoid fried and spicy foods.
Do not drink as much liquid as you normally do during a meal.
Avoid bending over and lying down with a full stomach.
Take walks.
Chew sugarless gum after eating.
Avoid eating just before bed time.
Prop yourself up with pillows when sleeping.
Take an antacid (do not use baking soda, it contains too much sodium).
See Section 6
Eat plenty of whole grains, fresh and dried fruits, and raw vegetables.
EXERCISE GUIDELINES FOR MOMS-TO-BE:
Before you begin exercising, check with your doctor to make sure the activities
you’ve chosen are safe. Exercising for 20-30 minutes three times a week is
usually recommended, although more frequent exercise is preferred. Follow
these simple guidelines:
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Avoid any jerking or bouncing movements, instead, use smooth flowing
movements. Low impact aerobics are acceptable (walking, treadmill,
etc.). Ask your doctor about continuing any aerobic workouts.
Don’t strain. Stop and rest when necessary and resume the activity when
rested.
Do not lie flat on your back after the fourth month.
Avoid exercising in hot, humid weather. Try to stay cool.
Exercise on a firm surface.
Do not hold your breath. Breathe completely and avoid becoming
winded.
Always drink water before, during, and after exercising.
Listen to the signals your body gives you. Stop if you get dizzy, feel pain
or cramps, lose muscle control, or can’t catch your breath.
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Do not participate in any activity or exercise that would cause you to
lose your balance (i.e. switch from your road bike to a stationary bicycle,
do your step class without the step, etc.).
Wear clothing that is comfortable and allows you to move freely.
After your baby arrives, resume your regularly pre-pregnancy routine
gradually. Listen to your body, it’s just been through a lot!
Pregnancy requires an additional 300 calories. If you exercise regularly,
you will need even more calories to keep your body going.
When exercising, be sure not to lock your knees while standing. Keep
knees slightly bent, and do not stand motionless for long periods of time.
If you keep moving and keep your joints slightly bent, you will keep the
blood flowing and help prevent dizzy spells.
COMMON EXERCISES DURING PREGNANCY:
LIGHT AEROBIC EXERCISE/LOW IMPACT:
Aerobic exercise stimulates your heart and lungs, improves your blood flow,
and expedites the use of oxygen. We recommend walking, swimming, and
riding a stationary bike to help you increase your strength. To resist fatigue,
always keep a comfortable pace.
CONDITIONING EXERCISES:
Conditioning exercises tone your abdominal wall and pelvic muscles preparing
you for childbirth. Performing these exercises will make your recovery quicker.
These are described below:
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KEGEL EXERCISE:
Tighten your pelvic floor muscles, as you do to stop urinating, and hold for
three seconds. Repeat groups of 10 to 12 several times a day.
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STRETCHING EXERCISES:
Stretching exercises not only make you more flexible, they also help relieve
some of the aches and pains of pregnancy.
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TAILOR SITTING:
While sitting on the floor, bend your knees and hold the soles of your feet
together in front of you. Slowly lean forward until you feel the stretch in your
inner thighs. When you feel the stretch, hold and gently push, do not force,
your knees towards the floor, you will feel stretching in your inner thigh and
pelvic floor. Hold this position for 30 to 60 seconds.
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HAMSTRING STRETCH:
Securely support yourself by holding onto the back of a chair with both hands.
While standing with your knees slightly bent, extend your right leg, heel down,
toes up. Keeping your heel firmly planted in front of you, slowly begin bending
your left leg. Bend at the waist and push your hips back without arching your
back! You should feel the stretch in your hamstring, located on the back of
your right thigh. Hold this position for 30 to 60 seconds, then repeat on the left
side.
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PELVIC TILT:
Get on your hands and knees keeping your back flat and straight, not arched,
and your knees comfortably apart. Tighten your pelvic and abdominal muscles
to arch your lower back. Hold for a count of five, relax, and return to starting
position. Repeat 10 to 12 times. Do not sag your stomach. This exercise is
excellent for lower back pain.
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CALF STRETCH:
Stand facing a wall. With your hands on the wall, place one foot about 12
inches in front of the other. While slowly leaning forward, bend your front
knee, keeping both heels on the floor, and hold your back leg straight. Make
sure your knee is directly aligned over your heel. You will feel stretching in
your back leg. Try to hold this position for 30 to 60 seconds. Switch legs and
repeat. Many women experience muscle spasms in their calves, especially at
night. Performing this exercise before going to bed can help relieve these
cramps.
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CALF HAMSTRING STRETCH:
While sitting with your legs spread apart in front of you, reach slowly toward
your left foot until you feel a stretch in the back of your thigh, and hold for 30
to 60 seconds. Then do the same toward the right foot.
THIRD TRIMSTER
WEEKS 28 through 40
26-30 WEEKS VISIT
PHYSICAL EXAMINATION & TESTING
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Interview with clinical staff
Weight check
Blood pressure check
Urinalysis
Fetal heartbeat
Glucose screening
Possible iron level check
If necessary, a Rhogam injection will be given between 28 and 32
weeks, following your antibody screening
SIXTH VISIT WILL INCLUDE
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Your doctor will talk to you about selecting a pediatrician.
CONTINUING VISITS (30 weeks – Delivery)
PHYSICAL EXAMINATION & TESTING
Your doctor may want to schedule more frequent examinations at this point.
You will need to schedule your next appointment based on your doctor’s
orders.
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Interview with clinical staff
Weight check
Blood pressure check
Urinalysis
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Fetal heartbeat
Possible iron level check
Regular pelvic exams will probably begin at 38 weeks.
(Depending on your situation, you may be having them already.)
QUESTIONS & ANSWERS
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You should attend a breast-feeding class. (If you are undecided about
whether or not to breast-feed, this class can help you with your decision.)
The doctor will discuss anesthesia, labor, and delivery expectations with
you, if this has not yet been done.
The nurse will give you an information sheet on symptoms of labor
which was also provided in folder given at initial visit.
You will be reminded that you will need to see the doctor four to six
weeks following your delivery. Please remember to schedule this
appointment as soon as possible after you deliver.
You should select a pediatrician that best suits your needs.
Disability forms regarding your maternity leave should be brought to the
office and left with the delivery physician’s office personnel. Please
allow 5-7 days for completion and return. If your company requires
earlier completion, please turn them in on an earlier visit. We encourage
you to work until delivery as disability is usually given for obstetric or
medical complications only!
Your hospital stay will vary according to the type of delivery that you
have - vaginal or Caesarean section. For a vaginal delivery, you should
plan on at least a 24-hour stay; the average is a 48-hour stay. (You
should also check with your insurance company to determine whether
you have an approved maximum length of stay).
YOUR BABY:
28-32 Weeks
During your last trimester, your baby will grow significantly. In fact, it will
more than double its weight. At this point, however, your soon-to-be newborn
only weighs two to three pounds and is 14-17 inches long. Lanugo, fine downy
hair, begins to disappear, first from the face, although vernix, a thick white
creamy substance, still covers the body and protects the skin. Your baby’s
vision has developed and his/her ears are now capable of picking up sound. If
you shine a light directly on your abdomen, your baby will react to it. Your
baby can also hear your heartbeat, as well as food moving through your body
and blood flowing through your uterus. You may also be surprised that your
baby knows your voice and enjoys certain kinds of music, but be aware that
loud music or sudden movements will cause your baby to jerk. This movement
is known as the startle reflex. You will become very familiar with it once your
baby is born. In fact, by this point in your pregnancy, your baby’s movement
probably has become more intense. This is because he/she has grown larger and
may squirm and kick instead of roll. If your baby seems inactive for any
extended period of time, lie down and relax for a few minutes, then count the
number of movements the baby makes during an hour. More than 10
movements per hour is fine. Repeat this during the day, and, if the number of
times the baby moves seems low, contact your doctor.
32-36 Weeks
By this month, your baby weighs approximately five pounds and is from 16 to
18 inches long. This is a time of tremendous growth, especially of the brain.
Most of the baby’s systems are well developed by this point, except the lungs,
which could still be underdeveloped. Calcium, protein and iron are very
important in these last few weeks for your baby’s growth. Your baby is
developing new skills that will allow it to eat, and taste buds are now present on
his/her tongue.
36-40 Weeks
Your baby is now plump with pink, smooth skin and can weigh from six to nine
pounds. Since your baby is much larger and is possibly engaged in the pelvis, it
may seem less active. The bones in the head are firm, but still soft enough to
allow the head to pass through the birth canal without injury.
YOUR BODY
Your prenatal visits will now be weekly, or as specified by the physician. These
visits will include a pelvic exam (38 weeks) in addition to the usual weight
check and lab work. It is possible to experience painless spotting immediately
after or within 48 hours of the pelvic exam. You may also notice an increase in
a mucous-like discharge after the pelvic exam. You may experience low
backaches, abdominal pressure, and leg pains. Vaginal discharge will likely
increase. These symptoms are normal, indicating that the baby has assumed the
birth position.
LIGHTENING (36-40 Weeks)
If you are a first-time mother, you may notice your baby’s head moving down
into the pelvis two to four weeks before birth. This is known as lightening. If
you have had other children, this lightening may not occur until labor begins.
When lightening takes place, the shape of your abdomen may change. This will
make it easier for you to breathe because your lungs will now have more room
to expand and your stomach will be less confined. You may also find
indigestion and constipation are no longer problems.
After lightening occurs, your baby’s head now presses on your bladder causing
frequent urination. Your baby’s new position may cause more leg cramps, thigh
pains, and aches in your pelvis. At the same time, your cervix will become
softer and thinner, which will help prepare your uterus for delivery. The term
for this softening and thinning of the cervix is “effacement.”
THE ONSET OF LABOR
When labor begins, some or all of the following symptoms will occur:
•
Regular contractions: For first-time pregnancies, the contractions should
be eight to 10 minutes apart for one to two hours. For succeeding
pregnancies, they should be 10 minutes apart for one hour. Use a watch
with a second hand to time from the beginning of one contraction to the
beginning of the next one.
•
•
•
Rupture of membranes (water breaking): There will be a sudden gush or
trickle of clear, watery liquid from the vagina that may or may not be
accompanied by contractions. If this occurs, notify your physician
immediately.
Spotting: Spotting may occur and/or blood-streaked mucous may be
present. Should you experience heavy bright-red vaginal bleeding, notify
your physician immediately.
You may experience a loss of your mucus plug. The onset of labor may
follow in days or weeks following the loss of the mucus plug. This is
your body’s way of preparing for labor.
If you go into labor during office hours:
Monday – Friday, 8:00 a.m. – 5:00 p.m. and Saturday 8:00am – 12:00pm ,
notify your physician through his/her clinical staff by calling the office. You
may be instructed to come into the office for an examination, or you may be
told to go directly to Labor & Delivery depending on your condition.
If you go into labor during non-office hours:
Call the office at (205) 930-1800 . If you are in labor, you will be instructed to
go to Labor & Delivery. After you are settled in a room in Labor & Delivery, a
family member should go to the Admissions desk of the hospital and present
your patient insurance information.
LABOR INDUCTION: WHEN IS IT DONE?
Inducing labor may be done for you if it is appropriate. Inductions are
either medically indicated or elective. Those that are medically indicated
are those that your physician believes will be safer from a complication for
you and/or your baby by delivering you early. Examples of medical
indications for induction would be growth problems with the baby,
maternal blood pressure problems, or post-dates (42 weeks gestational
age).
Elective inductions are those that are not medically indicated. These
inductions may by appropriate for some, but not for all patients. Your
physician can help you determine if you are a candidate for induction. Part
of the process is to determine if your cervix is favorable or “ripe”,
otherwise the induction could be a long process that may not be successful
and even result in a C-Section for you. Generally, labor that you do on
your own may be better that an induction .
CHECKLIST FOR HOSPITAL STAY:
EN ROUTE:
•
•
•
Cash for parking, if necessary
Watch or clock with second hand for timing contractions
Paper and pen for recording contractions
FOR LABOR (DELIVERY AND RECOVERY ROOM (LDR)
•
•
•
•
•
•
•
•
•
•
•
•
Lotion for massages
A baby name book (if needed)
Sugarless candy to keep your mouth moist
Books, magazines, playing cards
Warm socks and slippers
Address book or list of family and friends to be called
Robe and two or three nightgowns
Perfume, deodorant, powder, cosmetics, toothbrush, toothpaste
Hair brush, hair dryer, curling iron
Soap, shampoo, conditioner
Glasses or contact lenses (with necessary paraphernalia)
Cameras, film, tapes, and fresh batteries
GOING HOME ITEMS FOR BABY:
•
•
•
•
•
•
Infant car seat (mandatory state regulation)
One undershirt, socks or booties
Going home outfit
One receiving blanket
Sweater and cap, in cool weather
Heavy blanket, in cold weather
GOING HOME ITEMS FOR MOM:
•
•
•
•
•
•
Bra (nursing bra, if breast-feeding)
A roomy outfit
Panties and slip
Shoes, hosiery, or socks
Coat or sweater (if necessary)
Shopping bag to bring home gifts
POSTPARTUM
YOUR DOCTOR
•
•
•
•
•
•
You should have a postpartum check-up four weeks after a Cesarean
section or six weeks after vaginal delivery.
If you are not immune or rubella (German measles), you will receive a
rubella vaccine during your postpartum check-up if it was not given
while you were in the hospital.
You should continue your postpartum exercises.
You should discuss birth control options with your physician at your
postpartum visit.
Questions regarding breast-feeding can be directed to the hospital’s
Lactation Consultant.
Your annual Pap smear will be performed at your postpartum visit.
YOUR BODY
POSTPARTUM
Once you deliver the placenta or “afterbirth,” your body begins to recover. It
usually takes six to eight weeks for muscles and skin to regain their normal
tone. Because of hormonal changes, you should expect mood swings. After
delivery, the uterus, which is located at/or below the level of the navel, is
approximately the size of a grapefruit and feels firm. The uterus shrinks onehalf inch each day. Massaging the uterus and breast-feeding will help continue
this process. By the 10 th day after delivery, the uterus will have returned to
normal position in the pelvis. It is common to experience swelling in the lower
leg and feet soon after delivery. Elevate your legs above the hips, decreased
activity, and increase your water intake. If you experience headaches, shortness
of breath, dizziness, and/or nausea with swelling, contact our office.
EPISIOTOMY
Stitches from the episiotomy will dissolve in about two weeks. The episiotomy
site may itch as it heals. Discomfort from this procedure usually goes away in
two or three weeks. Follow these tips to promote healing and prevent infection
of the episiotomy site:
•
•
•
Keep the episiotomy site clean and dry.
After urinating, wipe front to back and use a squirt bottle of warm water to
rinse the episiotomy site. Pat area dry.
Take a shower instead of bath during the first few weeks. In some cases,
your doctor may recommend taking a sitz bath.
To relieve episiotomy soreness:
•
•
•
•
Apply ice packs to soothe and reduce swelling.
Take a sitz bath by sitting in three to four inches of very warm water for
20 minutes, two or three times a day as needed for 10-14 days
postpartum.
Apply anesthetic spray or Tucks pads (cotton pads soaked in Witch
Hazel).
Lie on your side with your knees up to relieve pressure and pain.
The Kegel exercise will help the vagina recover, (see page 15). Unlike some types of
exercises, you can begin doing the Kegel exercise immediately after you deliver. This
exercise contracts the vaginal muscles, helping to strengthen the vagina, which takes
about six weeks to regain its muscle tone and shape. If you do 20 sets of 10 repetitions a
day, your vagina should return to its normal tone much quicker.
BODY SECRETIONS
A day or so after birth, your body will begin to rid itself of extra fluid by
increased urination. You also may perspire heavily, especially at night. The
vaginal discharge you will notice for several weeks after birth is known as
“lochia.” It is blood and tissue left over from delivery. The amount and
appearance will vary from day to day. For the first few days, lochia is heavy
and bright red. Your flow may be heavier when you change positions or nurse
your baby. Gradually, the amount of lochia will lessen. The color will change
from bright red to dark red in color, and then brown to yellow to white to clear.
During this time, do not use tampons, and continue to avoid douches and
vaginal sprays. You can, however, use mini pads. A sudden increase in the
amount of lochia, or a return to a bright red color, signals the need for more
rest. Occasionally, heavy bleeding may occur for one to two hours two weeks
after delivery. This is usually due to the shedding of placenta scarring.
SHOULD YOU EXPERIENCE ANY OF THE
FOLLOWING SIGNS, CALL YOUR PHYSICIAN:
•
•
•
•
•
•
•
•
Heavy bleeding requiring more than one full-sized sanitary pad per hour
Unusual pain or pain that does not go away
Fever greater than 100º
Pain or burning when you urinate
Cracked or bleeding nipples
Reddened, tender areas in the breasts
Tender red streaks in your legs
Depression for more than two weeks
AFTERBIRTH PAINS
Contractions of your uterus that are similar to menstrual cramps are called
“after pains.” They can be painful, especially if you have had more than one
child. After pains often occur during breast-feeding and should disappear after
the first week. To relieve after pains, use prescribed pain medication as needed.
HEMORRHOIDS AND CONSTIPATION
You will probably have difficult bowel movements for a few more weeks. To
help ease them, drink plenty of liquids. Be sure to exercise your abdominal
muscles by walking regularly. Continue eating fresh fruits and raw vegetables,
and increase your intake of bran and whole grains. An over-the-counter stool
softener like Metamucil, Senokot, or Colace may be used.
SEXUAL ACTIVITY
Normal sexual relations may be resumed four to six weeks after your baby is
born. You may experience some discomfort during intercourse, and you should
inform your partner immediately if you do. If you are breast-feeding, you may
experience some vaginal dryness. Use of a water-soluble lubricant is
recommended.
It is not surprising that some women do not feel very “sexy” after delivery,
especially considering the lack of sleep and other demands of motherhood. It is
best to communicate these feelings with your partner and work together to
achieve your optimum sexual relationship.
PREGNANCY IS POSSIBLE
If you are bottle-feeding, you may begin to menstruate again six to eight weeks
after birth; however, your period may not start for several months if you are
breast-feeding. Ovulation often occurs before your periods resume, therefore,
the use of contraception is recommended. Whether bottle or breast-feeding,
remember that pregnancy can occur even in the absence of a period.
POSTPARTUM BLUES/DEPRESSION
Approximately half of all new mothers experience postpartum blues,
commonly known as the “baby blues.” Unhappiness, anxiety, mood swings,
and weepiness are just some of the common symptoms that occur during the
first six weeks after delivery and periodically reoccur. The major cause of
postpartum blues is the wide fluctuation in hormone levels.
Other contributing factors include the physical and psychological adjustments that must
be made, especially by a new mother. Such stress factors may include fatigue, guilt,
change in status, lower self-esteem, and negative body image, as well as the pressures of
caring for other children, housekeeping, and job concerns.
Try not to place too many expectations on yourself or your baby. Be determined to do
something nice for yourself. You should eat correctly, exercise, and nap\sleep when you
can. Most of all, do not be afraid to ask for help from those around you. Depression that
continues for two weeks or more that leads to a feeling of despondency, and an inability
to cope with the demands of daily life, is known as postpartum depression. The majority
of new mothers experience some feelings of depression, but postpartum depression lasts
longer and is more serious; however, it occurs in only 10 percent of new mothers. Should
you experience a severe continual feeling of depression, we recommend that you contact
your physician.
Remember, adjusting to parenthood is as demanding as it is rewarding. Check the list of
references below for further reading material on how to cope.
REFERENCES
The following is a list of excellent references to utilize during and after pregnancy.
1. What to Expect While You are Expecting, Eisenberg, Murkoff, and Hathaway.
Workman Publishing: New York , New York , 1989.
2. What to Expect the First Year, Eisenberg, Murkoff, and Hathaway. Workman
Publishing: New York , New York , 1989.
3. www.aap.org/family/brstguid.htm
4. AAP – A Woman’s Guide to Breastfeeding
YOUR BABY
IT IS IMPORTANT TO NOTE THAT THE BEST SOURCE OF INFORMATION
REGARDING THE HEALTH OF YOUR BABY AND ITS’ HABITS IS FROM YOUR
PEDIATRICIAN.
EATING PATTERNS
For the first few months, it is better to feed your baby on demand. Over several
months, a feeding schedule will develop. Make every effort for this time to be
enjoyable for both of you.
RULE OF THUMB FOR BREAST-FEEDING:
Every one and a half to three hours for 20-30 minutes.
RULE OF THUMB FOR BOTTLE-FEEDING:
In the first few days, expect the baby to drink between one and three ounces per
feeding. The amount of time between feedings is equivalent to the number of
ounces he/she drinks (i.e. one ounce equals one hour).
Regardless of whether you breast or bottle-feed, do not be anxious about counting ounces
or minutes, but never go longer than four hours between feedings. All is normal if your
baby wets five or six diapers per day and has regular bowel movements. Be aware that
babies go through growth spurts at three and six weeks and three and six months. They
may want to feed more frequently.
CALL YOUR PEDIATRICIAN IF YOUR BABY HAS
ANY OF THESE CONDITIONS:
•
•
•
Skin around the cord or circumcision is red, warm, and/or has a foulsmelling discharge.
Axillary (under arm) temperature measures less than 96º or greater than
99º, or rectal temperature is less than 98º or greater than 101º.
Baby struggles to breathe, grunts, has nostrils flaring with inspiration,
or takes more than 50 breaths per minute.
•
•
•
•
•
•
•
•
•
Baby shows no interest in feeding or sucking for more than a six-hour
period.
Baby has no wet diapers for more than a six-hour period after the third
day.
Skin is bluish around the mouth or over the whole body. (Blue hands and
feet mean baby is chilled).
Baby is shaking and very irritable.
Baby vomits forcefully, more than once, not the usual spitting up or
dribbling with burps.
Soft spot bulges.
There is a constant yellow discharge from the eyes.
Whites of eyes or whole body turns yellow.
Your instincts and observations tell you something is wrong.
HOW TO BUY A SAFE CAR SEAT
Today, it is required by law that all babies ride in a car seat until the age of
five. There are several types of car seats, and they fall into two basic
categories. You can use an “infant-only” car seat until the baby weighs 20
pounds. At that time, you must begin using a toddler-sized seat. All infant car
seats face the rear of the car and are light enough to double as a carrier
outside the car. Be sure to support the infant’s head and shoulders with a
rolled blanket or similar padding. Once you change to the toddler seat, install
it facing forward. If you have two cars, consider buying two seats, since the
baby must be in a car seat at all times. Household infant seats, carriers, and
travel beds are unsafe in the car, and it is even more dangerous to allow the
baby to ride in someone’s arms.
There is now a seat that can be used as both an infant and a toddler car seat
called the “convertible car seat.” It usually stays buckled in the car. It is
heavier and costs more, but is more cost-effective in the long run since you’re
not buying two.
There are many places you can buy car seats, such as children’s stores, drug
stores, and discount outlets. Or you could ask your hospital about renting or
buying one. We suggest you buy a car seat before your baby arrives so you can
learn how it works and how to install it in your car. When choosing a seat, ask
yourself these questions: Is it easy to use? Will it fit easily into my car? Is it
easy to fasten and unfasten? How difficult will it be to remove? How difficult
will it be to put my child in the seat?
All car seats are held in place by a seatbelt. Some also have a tether, which is
a strap on the back of the seat that gives extra security. This tether must be
permanently bolted to the body of the car. If it doesn’t have a tether, you can
move it between the front or back seats, although the back seat is safer. If your
car has a passenger side air bag, you must place the car seat in the back seat.*
*It is a state law that your baby be discharged from the hospital in an
approved car seat.
COMMON QUESTIONS
The following are some common questions asked during pregnancy. These
answers have been decided upon collectively by our physicians, although
answers may vary slightly, depending on the physician and the situation.
Is it normal to have bloody spotting?
No, but it is occasionally seen (i.e., following sexual intercourse, strenuous
exercise, or a Pap smear). This does not necessarily mean you will have a
miscarriage.
Is it normal to have a nosebleed during pregnancy?
Nosebleeds are normal and are usually caused by the increase in blood volume
and the thinning of the vessels in the lining of the sinuses during pregnancy. If
nosebleeds increase in frequency, please contact your physician.
Are backaches sometimes related to pregnancy?
Yes, a great deal of stress is placed on the lower back because the abdominal
muscles are relaxing, the center of gravity is changing, and the round
ligaments, which are attached to the uterus, are stretching as the uterus
enlarges.
What is the sharp, pulling pain I occasionally feel in my side?
It is round-ligament pain, which is caused by the stretching of these ligaments
due to weight gain and uterine growth.
May I travel long distances?
Yes, but only until you reach 34 weeks of pregnancy. After 34 weeks, you
should go no further than one hour away from the hospital without your
doctor’s permission. You should stop every one to two hours and walk for
about 10 minutes to increase circulation and prevent leg and feet swelling.
May I ride in a boat?
Riding in a boat is acceptable, as long as the ride is smooth and does not cause
a jarring motion.
May I water ski?
No, because of the possibility of abdominal injury.
May I participate on the rides at the amusement parks?
Yes, as long as the signs do not mention restrictions. Do not go on the rides that
swing or jerk.
May I go swimming?
Yes, provided you have not experienced a rupture of your membranes (water
breaking).
May I go to the dentist while I’m pregnant?
Yes, we encourage you to do so. Your dentist should use only local anesthesia
and must cover the abdominal area during all X-rays. No nitrous oxide may be
used.
May I go horseback riding?
No, because of the jarring motion and the possibility of being thrown from the
horse.
May I get a hair permanent?
Yes, after the first trimester (13 weeks). Remember, because of the changes in
your body related to pregnancy, the permanent may not take.
May I have my hair dyed?
Yes, after the first trimester (13 weeks).
What may I take for gas or indigestion?
Over-the-counter antacids – NO ROLAIDS.
May I use vapor rub or nose spray?
The use of vapor rub externally and saline nose spray is permissible. If dryness
and nosebleeds are a problem, you may want to consider a cool-mist humidifier
for your bedroom.
May I use a salt substitute?
No, because it contains potassium salts that could cause problems.
Are diet drinks okay?
Yes, after the first trimester (13 weeks), but try not to drink more than one a
day. If given a choice, use products with Aspartame or Sucralose.
May I drink coffee, tea, or drinks with caffeine?
In moderation. (No more than the equivalent of two cups of coffee per 24-hour
period.) Water is most important.
May I paint, use bug spray, or clean my oven?
Yes, in a well-vented room. Do not allow them to touch your skin. If you start
feeling faint, nauseated, or get a headache, leave the area immediately.
May I travel by plane?
Yes, with authorization of your attending physician. Some airlines require a
written letter from the physician authorizing travel by air. Remember, if you go
out of town, take a copy of your prenatal records with you.
Must I stop smoking during pregnancy?
Yes, It is harmful to both you and your baby. (Please see the warning against
cigarette smoking on page 36.)
When will I feel the baby move for the first time?
You may feel the baby move around 18 to 22 weeks. If this is not your first
pregnancy, you may feel movement earlier.
If I do not drink milk, how should I get the recommended amount of calcium?
It is especially important that you have four servings per day from dairy foods
such as cheese, yogurt, and cottage cheese. If you feel you are not getting the
proper amount of calcium, please talk to your doctor about a calcium
supplement.
May I douche during pregnancy?
No, because of the possibility of infection.
May I have intercourse throughout my pregnancy?
Yes. There are no restrictions as long as there are no complications (i.e.,
vaginal bleeding or premature labor). If in doubt, consult your physician.
Intercourse is not allowed once your water has broken.
May I exercise during my pregnancy?
Yes, but only in moderation as directed by your physician. Low impact or
prenatal aerobic exercise classes, as well as walking and swimming, are
recommended. Remember, do not lie flat on your back during any exercise.
May I use acne medication during pregnancy?
Yes, consult your physician for the permissible medications.
May I sit in a Jacuzzi or hot tub?
No, because your body temperature could become too high. This could be
harmful to both you and your baby.
May I use a tanning bed?
No, because the ultraviolet rays increases your body temperature.
May I use an electric blanket or heating pad?
It is permissible, as long as it does not raise your body temperature.
Is alcohol safe?
Since no safe level of alcohol consumption has been documented at any point,
our general recommendation is to avoid all alcohol intake throughout the entire
pregnancy. If you have any further questions, please consult your physician.
MEDICATION USE DURING PREGNANCY
Any medications taken during pregnancy could have an effect on the
developing baby; therefore, the best rule to remember during pregnancy is that
no drug may be assumed to be harmless. Unless prescribed by our physicians,
it is wise to avoid taking any medication during your pregnancy, even laxatives,
eye drops, nasal sprays, nasal drops, mild pain relievers, and external
ointments. If you have a condition that requires you to take medication
regularly, please discuss this with your physician. Should a special need for
medication arise, your physician will choose the safest drug available for you
and your baby. For more common conditions, the following list of drugs are
the only types of medication that our physicians have approved for you to use.
Please remember that these should only be used in moderation if you feel you
must take something.
RECOMMENDED MEDICATIONS:
COLD, COUGH, OR SORE THROAT
•
•
•
•
•
Tylenol or Extra Strength Tylenol: Take one or two every four hours
Tylenol Cold Formula, Actifed, Sudafed, Claritin, Claritin –D,
Chlortrimeton
Chloraseptic throat spray, Cepacol lozenges or gargle every two hours
with one cup of warm water containing 1 teaspoon of salt.
Nasal sprays or saline drops use as directed (Afrin twice daily)
Robitussin DM, Delsym, or Hall’s cough drops use as directed.
HEADACHE OR FEVER
•
Tylenol (Acetaminophen) Regular or extra strength take 1-2 every four
hours
INDIGESTION/REFLUX SYMPTOMS
•
•
•
Elevate the head of your bed on a brick or thick board
Use Maalox, Mylanta, Gaviscon, Riopan Plus, or Tums
Use Pepcid AC, Zantac, or Prilosec OTC (these can be taken daily if
needed)
NAUSEA AND/OR VOMITING
•
•
•
•
Use Emetrol or Emecheck as directed on the label
Vitamin B-6 may also be taken
Non-drowsy Dramamine as directed on the label
If nausea or vomiting affects your fluid or food intake for more than 1
day, contact our office
CONSTIPATION
•
•
•
•
•
Use Metamucil, Citracel or Fibercon as a fiber bulking agent
Use Colace (stool softeners) 100mg at bedtime or twice daily
Fruits, prunes, and all types of whole bran cereal are also helpful in the
prevention of constipation
For acute constipation try Milk of Magnesia, Senokot, Dulcolax tablets
or suppositories, or glycerin rectal suppositories
If the above recommendations are unsuccessful, a Fleet enema may be
used as needed
DIARRHEA
•
•
Kaopectate (use only for 1 day, as directed)
Imodium AD use as directed
HEMORRHOIDS
•
•
Preparation H Cream or suppositories, Anusol cream or suppositories or
Tuck pads
Warm sitz baths with Epsom Salts
YEAST INFECTIONS
•
Monistat 3 (or generic brand) or GyneLotrimin (after the first trimester,
be careful inserting the applicator)
FOR ANY QUESTIONS REGARDING MEDICATION USE DURING
PREGNANCY PLEASE CALL THE OFFICE DURING REGULAR BUSINESS
HOURS BETWEEN 8:00 AM AND 5:00PM MONDAY THROUGH FRIDAY AND
8:00-12:00 ON SATURDAY.
CALLS MADE TO THE ANSWERING SERVICE AFTER HOURS SHOULD BE
LIMITED TO EMERGENCY SITUTATIONS ONLY.
OTHER CONCERNS
During your pregnancy, you should be aware of certain substances that can
affect the health of you and your baby. We urge you to adhere to the following
guidelines.
LEAD
Because lead can be dangerous to the developing fetus, the Food and Drug
Administration has issued a warning to pregnant women concerning its use.
When a container made with lead is used for coffee, tea, or other acidic
beverages, especially when they are heated, the lead in the container can pass
into the liquid. This warning also applies to the housing of acidic foods such as
tomato sauce and fruit juices in containers made with lead. Ceramic mugs, lead
crystal (including lead crystal baby bottles), pewter, and sliver-plated
hollowware are some common lead containers that should be avoided. For daily
use, pregnant women are encouraged to use regular glassware and plastic.
CONTAMINATED FISH
Although PCB’s or polychlorinated biphenyls (industrial residues) were banned
in 1979, they continue to linger in our nation’s waters. As a result, they are
often found in the tissues of salmon, swordfish, and lake whitefish. If ingested
in large enough doses by pregnant women, or women who may become
pregnant, they can harm the developing fetus.
Mercury, which is released into our waters by the burning of fuels and
industrial waste, accumulates in larger fish that live for many years, such as
tuna, shark and swordfish. Consumer Report says that the most prudent
approach for women who are pregnant, or who may become pregnant, is to
avoid eating these fish altogether. On the other hand, many experts believe it is
safe for women to include these fish in their diets as long as they avoid
excessive amounts of any particular kind. Tuna presents the biggest concern
since other fish such as swordfish, salmon, lake whitefish and shark, are rarely
consumed in large quantities in our culture. Experts also suggest that pregnant
women who do not give up fish should limit their intake to once or twice per
week.
ARTIFICIAL SWEETENERS
Aspartame and Sucralose (Splenda ), artificial sweeteners that occurs
naturally in all complete-protein foods, has been determined to be safe for
consumption. However, our physicians recommend that you choose Aspartame
or Sucralose rather that saccharine. However, we also recommend that you
limit your intake of artificial sweeteners as well as caffeine. Talk with your
doctor is you have any questions.
ALCOHOL
No safe limit of alcohol has been found for pregnancy. We recommend that you
omit alcohol entirely.
CIGARETTE SMOKING
Cigarette smoking during pregnancy exposes you and your baby to
approximately 1,000 different chemicals. A pregnant woman who smokes one
package of cigarettes a day will inhale smoke approximately 11,000 times
during an average pregnancy and may spend 10 percent of her waking day
smoking. Scientific evidence indicates smoking during pregnancy increases the
risk of death to an unborn infant, damage to the fetus while in the uterus, and
complications for the mother during pregnancy.
Tobacco smoke contains many harmful components, such as nicotine, carbon monoxide,
hydrogen cyanide, tars, resins, and potential carcinogens. The diverse nature of tobacco
smoke makes it difficult to tell exactly which chemical is responsible for the side effects.
A scientific study originally published in 1957 reported a lower birth weight for those
infants born to mothers who were smokers. There have been over 45 studies involving
500,000 deliveries that have confirmed this original scientific study. Children of mothers
who smoked during pregnancy have been observed to have significantly lower IQ scores
and a higher incidence of reading disorders than offspring of non-smokers. A higher
incidence of minimal brain dysfunction syndrome (hyperactivity) is also reported in the
children of mothers who smoke.
Cigarette smoking during pregnancy also increases the risk of spontaneous miscarriage,
fetal and neonatal death. Smoking not only increases the risk of fetal damage, but also
increases the incidence of serious complications in the mother. The possibility of damage
to the placenta (the organ through which the baby receives oxygen and nutrients) and
incidence of placenta previa (abnormal location of the placenta) are both increased in
smoking mothers.
Smoking during pregnancy creates an extremely high-risk condition for both baby and
mother. It is our position that if you are pregnant, you should stop smoking entirely
and permanently at this time. It is also our position that if you continue to smoke while
pregnant, you assume responsibility for the risks. The American Lung Association offers
an eight week class for those who are interested in a group setting for instruction and
support while “kicking the habit.” Please call your local chapter and ask about the
Freedom From Smoking class in your area.
SPECIAL TEST INFORMATION
AFP-TRIPLE SCREEN TEST
The alpha-fetoprotein (AFP) test helps identify a small number of women
whose unborn babies may have certain defects such as Down’s Syndrome or an
open neural tube defect. This test is available to women who are between
weeks 15 and 19 of their pregnancies. A small amount of blood is drawn from a
vein in the arm of the pregnant woman and is then tested for a variety of
factors. Through this screening test, an open neural tube defect can usually be
identified. It can detect approximately 50% of cases of Down’s Syndrome. The
downside of the test is that it has a 90% false positive rate. Women who have a
positive blood test will need amniocentesis for further evaluation. We will be
glad to answer any questions you have concerning this matter.
GLUCOSE SCREENING
During pregnancy, the metabolic system experiences added stress. In some
women, this additional stress results in a temporary rise in the blood sugar
level. For this reason, your blood sugar level will be tested between 24 and 30
weeks. You will be notified as to when you should schedule your glucose
screening. You will be given some Trutol, which is a sweet drink containing a
measured dosage of glucose. An hour later, a blood sample will be drawn. You
will be notified if your glucose level is elevated. If it is, you should begin
following the special diet you will be given and schedule a follow-up blood
sugar test.
Please remember that an elevation in your glucose level does not mean anything is wrong
with you or your baby. It does mean, however, that you will need to make some changes
in your diet, and we will have to do some additional testing.
NON-STRESS TEST (NST)
In the last trimester, you may need a non-stress test (NST). During an NST, two
monitor straps are placed around your abdomen to check the baby’s heartbeat
and any contractions you might be having. (This is the same type of monitoring
you will have in the labor room at the hospital.) This test lasts approximately
20 minutes. You will be monitored while lying in a recliner. If you need this
type of test, it may be performed on a weekly basis. You will see the doctor
with each scheduled NST appointment.
GROUP B STREP INFORMATION
Group B Strep is normally found in the vagina of 15% to 40% of all healthy
adult women. Group B Strep should not be confused with Group A Strep which
causes strep throat. GBS does not cause problems for the adult female. Most
women carry it and don’t know it.
GBS can cause illness in babies born to women with GBS. Therefore, your HWWC
physician will check for GBS between 35-37 weeks. If the test is positive, you will be
notified as well Labor & Delivery. You will be treated with antibiotics while you are in
labor & delivery. Treatment is not recommended before labor & delivery because the
transmission of the bacteria usually would occur during labor and/or delivery.
CYSTIC FYBROSIS TESTING INFORMATION
Cystic Fibrosis is a genetic disease that causes breathing problems, lung
infections and digestive problems. These problems can require daily medication
and respiratory (lung) therapy. Cystic Fibrosis does not cause a person to have
learning problems or to look different.
Most people that have a child with cystic fibrosis DO NOT have a family history of
cystic fibrosis. Gene carriers have one altered copy of the CF gene and one normal copy.
They do not have any symptoms of CF. Individuals with VF have two altered copies of
the CF gene. If both parents are CF carriers they have a 1 in 4 chance (25%) to have a
child with CF.
Couples with the greatest chance to be a CF carrier that are planning a pregnancy or
seeking prenatal care should consider CF Carrier Testing. You should also consider
testing if you or your partner has a family member with CF. Testing should be considered
if you are partners with an individual with CF or CF carrier.
If you are interested in getting tested you should discuss this with your doctor or genetic
counselor. The test will require a blood sample taken from the arm.
For more information about Cystic Fibrosis please contact the following organizations:
Cystic Fibrosis Foundation
6931 Arlington Road
Bethesda, MD 20814
1-800-FIGHT CF
www.ccf.org
March of Dimes
1275 Mamaroneck Avenue
White Plains, NY 10605
1-800-MODIMES
www.marchofdimes.com
UAB Department of Genetics
Hugh Kaul Genetics Building
720 20 th Street South
Suite 241
Birmingham, AL 35294-0024
(205) 934-4983
CHORIONIC VILLI SAMPLING
This test is used to test for chromosomal abnormalities and genetic birth
defects. Women who are over the age of 35 should consider CVS because of
the increased risk of Down Syndrome and other chromosomal conditions.
Women who have had a previous child with a genetic birth defect (including
chromosomal), a family history of a genetic disorder, or an abnormal first
trimester screening should also consider CVS.
The ideal time to have the test done is 10-12 weeks of pregnancy. Using an ultrasound as
a guide, the health care provider inserts a thin tube through the vagina and cervix to take
a tiny tissue sample from outside the sac where the baby develops.
The risks associated with CVS are a small risk of miscarriage (1 in 100 or less). Some
women have cramping or spotting after the procedure. Studies suggest that the procedure
may pose a very small risk (about 1 in 3000) of birth defects involving missing or
shortened fingers or toes.
This test is only available at Vanderbilt University in Nashville, TN.
ULTRASOUND
We recommend that all obstetrical patients have an ultrasound between the 17
th and 22 nd weeks of pregnancy. An ultrasound (or sonogram) is a test that
uses sound waves to project an image on a screen, thus allowing your doctor to
check your baby’s growth. There are no known side-effects to the baby from an
occasional ultrasound examination.
This test requires no special preparation. (You will not need to have a full bladder.)
During the exam, you will lie on your back and a gel will be spread over your bare
abdomen. This gel improves the conduction of sound as the transducer is moved over
your abdomen. The echoes produced as the sound waves bounce off parts of the baby are
recorded. Depending on the position of the fetus, you may be able to see the head, arms
and legs, and even the beating heart. If you are in the early stages of pregnancy (before
16 weeks), we may use a device called a transvaginal probe, which is inserted into your
vagina just like a tampon and enables us to see early pregnancy with great accuracy. The
exam will not hurt you or your baby.
By providing this service in our office, we are able to offer convenience, as well as lower
medical costs for our patients; however, some insurance companies do not provide
coverage for these charges. After your ultrasound appointment, you will see the doctor
for a routine visit.
We also offer ultrasounds for the purpose of sex determination. There is an additional fee
for this particular procedure, and it will not be filed with your insurance company. You
may be required to pay at the time of the procedure. Sex determination can usually be
detected after 24 weeks (six months) of pregnancy.
ON THE DAY OF YOUR ULTRASOUND
Our ultrasounds are performed by registered sonographers. These qualified
technicians are delighted to be a part of your birthing experience. To make this
experience the best it can be, please allow the sonographer to complete the
diagnostic test before asking questions. During this time, the technician’s full
attention will be on you and your baby. Measurements will be made to
calculate your due date and your baby’s weight. Your baby’s head, abdomen
and extremities will be evaluated for abnormalities. When the test has been
completed, the sonographer will gladly show you your baby.
Family members are welcome to view the ultrasound. In order to have your
ultrasound performed in a timely manner, please follow these suggestions:
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Children and other family members are always welcome, but please
remind them to watch quietly. Space is limited.
Please keep children off the scan table for their own protection.
It is best to save questions until the ultrasound is completed. The
sonographer will be glad to answer any questions at this point, or refer
you to your doctor for further explanation.
Because of the number of pre-scheduled ultrasounds performed every
day, your patience is greatly appreciated if an emergency test has to be
worked into the schedule; however, if you have not been notified of a
delay and have been waiting over 20 minutes, please see the receptionist.
PLEASE NOTE: In the course of performing a basic screening ultrasound,
abnormalities or congenital anomalies of the fetus may be detected; however, it
is not intended to detect all fetal abnormalities. You should be aware that a
normal result on a basic screening ultrasound is not a guarantee that your baby
will be born without birth defects.
AMNIOCENTESIS
An amniocentesis may be performed during pregnancy to help determine an
inherited, genetic abnormality that the fetus may have. This procedure involves
the careful passage of a thin needle through the abdomen of the mother and into
the sac of the amniotic fluid surrounding the fetus. (This is done under
ultrasound-guidance.) A small amount of the fluid is then withdrawn for
analysis.
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WHO SHOULD CONSIDER IT? The principle reasons for genetic
amniocentesis are: maternal age of 35 years of older (at time of
anticipated delivery), and a previous child with a proven chromosomal
abnormality. Other reasons, which rarely occur, include testing for
unusual enzyme deficiencies, neural tube (brain and spine) defects,
sickle cell disease, and so forth. These often require additional
counseling with a geneticist.
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WHAT IS GENETIC AMNIOCENTESIS: Genetic amniocentesis is
usually performed on an outpatient basis. This test is able to detect fetal
sex and almost all chromosomal abnormalities. It is also able to detect 85
to 90 percent of neural tube defects by taking a sample of amniotic fluid
and testing the level of alpha-fetoprotein.
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WHAT ARE ITS LIMITATIONS?
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It cannot detect non-chromosomal congenital abnormalities such
as cleft palate, intestinal or cardiac abnormalities, etc., which
occur in approximately three percent of pregnancies.
Its accuracy exceeds 99.9 percent, but cannot be totally
guaranteed. There is a very remote possibility of error (one in
10,000 cases) in the interpretation of fetal cells grown from
amniotic fluid.
Fluid cannot be obtained on rare occasions because of technical
difficulties or decreased amounts of fluid. The attempt must be
postponed if this occurs.
A second amniocentesis (seven to 14 days later) is needed on rare
occasions because cells in the initial sample may not have grown
enough to permit valid interpretation.
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WHAT ARE THE RISKS? The principle risk of amniocentesis is
spontaneous abortion (miscarriage), which occurs very rarely. Additional
risks include, but are not limited to, death, possible fetal or maternal
injury, infection or bleeding. Because there is a risk involved, it is
important to note that this test is only recommended when there is a
specific reason to believe that a detectable genetic disease may be
present. The occurrence of these complications in our practice is unusual
for several reasons. Most importantly, the physicians who perform this
procedure are very experienced practitioners. Secondly, ultrasound is
utilized to help determine the gestational age of the fetus, the position of
the placenta, and the best area for the proper and safe placement of the
amniocentesis needle.
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WHAT IS THE COST? Essentially, there are two categories of
charges: the charge for the procedure, and the charge for the laboratory
analysis. If you do not have insurance, you will need to pay for the
procedure prior to having it performed. If you do have insurance, it will
be filed, and you will be billed for the amount not covered by your
insurance.
GLOSSARY
The list of terms pertains to pregnancy, labor, and delivery. Most of these terms are found
in this booklet. Others may come up in further reading or discussions with your doctor.
Afterbirth: Placenta and membranes that are expelled after the birth of the
child.
Afterbirth Pains: Uterine cramps due to contraction of the uterus, occurring
during the first few days after childbirth. Usually the pain is more severe during
nursing, but rarely lasts longer than 48 hours after your baby is delivered.
Alpha-fetoprotein (AFP): A protein produced by a growing fetus; it is present
in amniotic fluid and, in small amounts, in the mother’s blood.
Amniocentesis: A procedure in which a small amount of amniotic fluid is
taken from the sac surrounding the fetus and tested to detect genetic disorders
or maternal-fetal blood incompatibility.
Amniotic Fluid: The liquid contained in the amnion. This fluid is transparent
and almost colorless. The liquid protects the fetus from injury, and helps
maintain an even temperature.
Amniotic Sac: Known as the amnion; a thin transparent sac that holds the fetus
suspended in amniotic fluid.
Antibody: A protein produced in the blood as reaction to foreign substances in
the blood.
Apgar Score: A system of scoring infant’s physical condition one minute and
five minutes after birth. The heart rate, respiration, muscle tone, response to
stimuli, and color are rated 0, 1 or 2. The maximum score is 10.
Areola: Circular dark area surrounding the nipple.
Arterioles: Small arteries that can become larger and smaller, lowering and
increasing the blood pressure.
Axillary Temperature: Body temperature checked by using a thermometer
under the armpit.
Blood Pressure: The force of the blood against the wall of the arteries.
Braxton Hicks Contractions: Uterine contractions which occur at various
times during pregnancy. They are random, usually are not painful, do not
increase in frequency, and do not dilate the cervix. They are not true labor
contractions.
Breech Presentation (Position): A situation in which a fetus is positioned to
be born buttocks or feet first.
Caesarean Birth (C-Section): Delivery of a baby through an incision made in
the mother’s abdomen and uterus.
Cervix: The opening to the uterus.
Chorionic Villus Sampling (CVS): A procedure to test for genetic fetal
defects. CVS can be done earlier than amniocentesis - usually between 9 and 11
weeks of pregnancy.
Circumcision: Surgical removal of the end of the foreskin of the penis.
Circumcision is usually performed at the request of the parents. There are very
few medical indications for this procedure.
Cleft Palate: An abnormality resulting from failure of facial processes of the
embryo to fuse, which results in the roof of the mouth forming an opening
between the mouth and nasal cavities.
Colostrum: A thin white fluid discharged from the breasts at the beginning of
milk production, usually noticeable during the last few weeks of pregnancy.
Contraction: A shortening or tightening of uterine muscles where the
sensation is felt in the abdomen, back, or both.
Contraction Stress Test: Used to test the condition of the fetus. Mild
contractions of the mother’s uterus are induced and the fetal heart rate is
recorded in response to the contractions.
Doppler: A form of ultrasound that reflects motion such as the fetal heartbeat
in audible signals.
Down’s Syndrome: A genetic disorder causing moderate to severe mental
retardation and physical abnormalities. Women at high risk of giving birth to a
child with Down’s Syndrome are those over 35, or those who have had a
previous child with the syndrome.
Eclampsia: Another name for seizures during pregnancy that occur because of
high blood pressure.
Ectopic pregnancy: Pregnancy that occurs outside the uterus, most often in the
fallopian tubes.
Edema: Swelling.
Effacement: During the normal process of delivery, the dilation of the cervix,
enlarging the cross-section area of the canal to permit passage of the fetus.
(Softening of the pelvis).
Electronic Fetal Monitoring: A method in which electronic instruments are
used to record the heartbeat of the fetus and contractions of the mother’s uterus.
Embryo: Stage in prenatal development between the ovum and the fetus.
Between the 2 nd and 8 th week.
Endometriosis: A condition in which tissue that looks and acts like the tissue
lining the uterus grows outside the uterus.
Epidural: A form of anesthesia used during labor. It is given via a narrow
catheter threaded through a needle inserted into the space immediately around
the spinal cord.
Episiotomy: An incision between the vagina and rectum made during
childbirth to widen the vaginal opening.
Estradiol Level Test: A test used in infertility treatment to determine estrogen
levels in the blood. This can help determine when ovulation occurs.
External Version: A technique performed late in pregnancy in which the
doctor manually attempts to move a breech baby into the normal, head down
position.
False Labor: During the final weeks or days of pregnancy, many women
experience the contractions of false labor. These contractions are considered
false labor because they do not become more frequent and they are not
accompanied by dilation of the cervix or descent of the fetus.
Fetal Distress: Problems with the baby which occur before birth that endanger
the baby and require immediate delivery.
Fetoscope: An optical device, usually flexible and made of fiberoptic
materials, used to view the fetus in the uterus.
Fetus: The child in utero from the third month to birth. Prior to that time it is
called an embryo.
Forceps: Special instruments placed around the baby’s head to help guide it
out of the birth canal during delivery.
Fontanelle: A soft spot lying between the cranial bones of the skull of a fetus.
Gestational Diabetes: A disorder occurring only during pregnancy resulting
from inadequate production or utilization of insulin. It can be controlled by diet
and/or may require insulin injections. It is estimated to occur in about 3% of
pregnancies and usually disappears after delivery.
Glucose: A sugar. In medicine, the word is used to indicate the sugar dextrose.
Glucose is the most important carbohydrate in body metabolism.
Glucose Screening: A blood test given, ideally between the 24 th and 28 th
week of pregnancy, identifying persons who should have a 3-hour glucose
tolerance test to rule out gestational diabetes.
Hemophilia: A hereditary blood disease in which the blood fails to clot and
abnormal bleeding occurs.
High-Risk Pregnancy: A pregnancy with complications that need special
medical attention. Examples include: previous C-section, advanced maternal
age, history of miscarriages, uterine abnormalities, and smoking during
pregnancy. Your doctor will determine if you have any of these risk factors.
Induced Labor: Labor that is started or speeded up through the intervention of
a doctor, usually by using a drug.
Kegel: An exercise for strengthening the pubococcygeal and levator ani
muscles. Strengthening these muscles aids in childbirth, controlling urinary
incontinence, and may enhance the pleasure derived from sexual intercourse.
Lactation: The function of secreting milk.
Lanugo (Down): Fine soft hair covering the skin of the newborn.
Laparoscopy: An operation in which the organs inside the lower abdomen can
be viewed through a lighted telescope.
Lightening: Descent of the presenting part of the fetus into the pelvis. This
often occurs two to three weeks prior to the beginning of the first stage of labor.
Linea Nigra: Dark line from the pubic bone to the navel.
Lochia: Vaginal discharge after delivery.
Maternal Serum Alpha-fetoprotein (MASAFP Screening): Test of the
amniotic fluid level used to evaluate fetal development.
Membrane: A thin, soft, pliable layer of tissue that lines a tube or cavity,
covers an organ or structure, or separates one part from another.
Midline Incision: A vertical incision made from the navel to the pubic bone
for Caesarean birth.
Miscarriage: Spontaneous loss of a pregnancy before the fetus can survive
outside the uterus.
Natural Childbirth: Childbirth where breathing, relaxation, and massage
techniques are used in place of medication.
Neural Tube Defects: Fetal birth defects that result from improper
development of the brain or spinal cord.
Non-Stress Test (NST): A test in which fetal movements felt by the mother or
noted by the doctor are recorded, along with changes in fetal heart rate.
Obstetrician: A physician who treats women during pregnancy, labor, and
delivers the infant.
Ovulation: The monthly release of an egg from one of the ovaries.
Perineum: The area between the vagina and the rectum.
Placenta (afterbirth): Tissue connecting mother and fetus that brings
nourishment and takes away waste.
Pediatrician: A physician who specializes in pediatrics; the care of infants and
children and the treatment of their diseases.
Placenta Previa: A condition in which the placenta lies very low in the uterus,
so that the opening of the uterus is partially or completely covered.
Preeclampsia: A condition of pregnancy in which there is high blood pressure,
swelling due to fluid retention, and abnormal kidney function.
Premature: A baby born before 37 weeks.
Prenatal: Existing or taking place after birth.
Prenatal Care: Program of care for a pregnant woman before the birth of her
baby.
Postpartum: Occurring in the period shortly after childbirth.
Rh Immune Globulin (RhIG): A drug that suppresses an Rh negative
person’s antibody response to Rh positive blood cells.
Rhogam Injection: RhoGAM is a trade name for Rho (D) immune globulin.
Round Ligament: Two round cord-like structures passing from the front of the
body of the uterus into the anterior wall of the broad ligament, below the
fallopian tubes, outward through the inguinal canals to the soft tissues of the
labia majora.
Rubella: An acute infectious disease resembling both scarlet fever and measles
(German Measles.)
Show: Blood-tinged mucous-like discharge.
Sickle Cell Disease: A hereditary chronic form of anemia in which abnormal
sickle or crescent-shape blood cells are present. This is mostly found in the
African-American population.
Sonographer: A technologist trained in the application of ultrasound for
diagnostic and therapeutic purposes.
Tay Sachs disease: An inherited disease transmitted as an autosomal recessive
trait mostly found in the Ashkenazi-Jewish population of Eastern Europe .
Toxoplasmosis: A disease caused by an organism found in raw and rare meat,
garden soil, and cat feces. The disease, which is generally not harmful to adults,
can cause injury to the fetus and the placenta.
Transverse Position: When the fetus is positioned crosswise in the uterus.
Trimester: Each three-month period of pregnancy. Pregnancy is divided into
three trimesters of equal length.
Tubal Occlusion: Blockage of the fallopian tubes.
Ultrasound: A test in which sound waves are used to examine the fetus or
view the internal organs.
Varicose veins: Enlarged twisted superficial veins. May occur in almost any
part of the body, but are mostly commonly observed in the legs.
Vacuum Extraction: The use of a special instrument that attaches to the
baby’s head and helps guide it out of the birth canal during delivery.
Vernix: Creamy white covering over the skin of the baby.
Vertex Presentation: A position normally assumed by a fetus before labor and
delivery in which the head is positioned down, at the top of the birth canal,
ready to be delivered first.
Urinalysis: A specimen of urine used for testing purposes.
Uterus: An organ of the female reproductive system for containing and
nourishing the embryo and fetus from the time the fertilized egg is implanted to
the time for birth of the fetus.
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