What to Expect When You're Expecting

date Jan 28, 2019
authors Heidi Murkoff and Sharon Mazel
reading time 20 mins

Table of Contents

First signs

How does home pregnancy test (HPT) work?

All HPTs measure urinary levels of human chorionic gonadotropin (hCG), a (developing) placenta-produced hormone of pregnancy. HCG finds its way into your bloodstream and urine almost immediately after an embryo begins implanting in the uterus, between 6 and 12 days after fertilization.

Late period of early miscarriage

Unfortunately, it sounds like you may have experienced what’s known as a chemical pregnancy—when an egg is fertilized, but for some reason never completes implantation. Instead of turning into a viable pregnancy, it ends in a period. Though experts estimate that up to 70 percent of all conceptions are chemical, the vast majority of women who experience one don’t even realize they’ve conceived.

Calculation: LMP (last menstrual period)

The 40 weeks of pregnancy are not counted from the day your baby was conceived—they’re counted from the first day of your last menstrual period (or LMP). Why start the clock on pregnancy before sperm even meets egg (and before your ovary even releases the egg)? The LMP is simply a reliable day to date from.

Space out pregnancies for at least 18 months

Getting the best prenatal care, starting as soon as you think you’re pregnant. Very closely spaced pregnancies (when there’s less than 12 months between pregnancies) increases the risk for preterm birth, though getting good prenatal care from the get-go can help reduce that risk.

After age 35

Eliminate or minimize as many risk factors as you can, and you’ll be able to take years off your pregnancy profile—making your chances of delivering a healthy baby virtually as good as those of a younger mother. Yes, maybe even better. So relax, enjoy your pregnancy, and be reassured. There’s never been a better time to be over 35 and expecting a baby.

Tests and vaccine

Rh factor

All pregnant women are tested for the Rh factor early in pregnancy, usually at the first prenatal visit. If a mom-to-be turns out to be Rh positive, as 85 percent of the population is, the issue of incompatibility isn’t an issue at all. That’s because whether the baby is Rh positive or Rh negative, there are no foreign antigens on fetal red blood cells to cause mom’s immune system to mobilize against them.

Gestational diabetes

Almost all practitioners screen for gestational diabetes (GD) in almost all expectant moms at about 24 to 28 weeks. Moms who are at higher risk for GD (including older or obese mothers or those with a family history of diabetes) are screened even earlier in their pregnancies.

Workout, Sleep and relaxation

Temperature rises

If you’ve always used strenuous workouts as a way to burn off extra calories you’ve eaten, it’s time to trade in that strategy for a healthier approach. Also avoid any exercise that raises your temperature excessively, which isn’t safe during pregnancy (saunas and hot yoga are out).

Not on the back

Relax in the right position. It’s best to avoid spending a lot of time on your back after the 4th month… Stay off your back. After the 4th month, don’t exercise flat on your back. The weight of your enlarging uterus could compress major blood vessels, restricting circulation.

Try not to cross Legs

Exercising regularly (to improve circulation and leg strength) and getting into the habit of not crossing your legs (which restricts blood flow) will also help keep spider veins at bay.

Kegel!

Just 5 minutes of Kegels, 3 times a day, and you’ll tone your way to a long list of both short- and long-term benefits. Toned pelvic floor muscles can ease a host of pregnancy and postpartum symptoms from hemorrhoids to urinary and fecal incontinence.

Many benefits of exercising

  • tend to have shorter labors and are less likely to need labor and delivery interventions
  • Your postpartum recovery
  • babies of moms who exercise during pregnancy are born at healthier weights, are better able to weather labor and delivery
  • Babies of pregnant exercisers, on average, tend to sleep through the night sooner, are less prone to colic, and are better able to soothe themselves

How much to sweat?

A little sweat is fine, a drenching sweat is a sign to slow down. So is being unable to carry on a conversation as you go. Work hard enough so you feel yourself breathing more heavily, but not so out of breath that you aren’t able to talk, sing, or whistle while you work(out). Needing a nap after completing a workout means you’ve likely worked too hard. You should feel energized, not drained, after exercising.

Avoid abdomen exercises

Full sit-ups or double leg lifts pull on the abdomen, so they’re probably not a good idea when you’ve got a baby on board. Also avoid any activity that requires “bridging” (bending over backward) or other contortions, or that involves deep flexion or extension of joints (such as deep knee bends), jumping, bouncing, sudden changes in direction, or jerky motions. Choosing the

Posture

  • Use a footrest to elevate your feet slightly
  • Don’t cross your legs, which can cause your pelvis to tilt forward
  • Don’t sit too long
  • Try not to stand too long, either
  • Be a slow lifter. Avoid lifting heavy loads, but if you must, do it slowly.
  • Try to keep weight gain within the recommended parameters
  • Wear the right shoes
  • Sleep right
  • When getting out of bed, swing your legs over the side of the bed to the floor

Be careful of over stretching due to relaxin

Relaxin, the pregnancy hormone that loosens the ligaments and joints around your pelvis so your baby can fit through the exit, doesn’t discriminate between the ligaments you’d want loosened up (like those pelvic ones) and those you’d rather it just leave alone (like those in your feet).

Sleeping position

Curling up or stretching out on your side—preferably the left side, though either side is fine—with one leg crossed over the other and with a pillow between them, is ideal for both you and your baby-to-be. It not only allows maximum flow of blood and nutrients to the placenta but also enhances kidney function, which means better elimination of waste products and fluids and less swelling of ankles, feet, and hands.

Food and nutrition

Take folate!

A diet that lacks necessary nutrients (especially folate, the dietary version of folic acid) increases your risk for premature delivery, while a diet that’s nutrition packed decreases that risk.

Prenatal vitamin

In the real world—the one you most likely live in—a prenatal supplement provides extra health insurance for you and your baby, covering those nutritional bases when your diet doesn’t. And that’s why taking one daily is recommended. Still, a supplement is just a supplement. No pill (or powder), no matter how complete, can replace a good diet.

Natural !== Safe

Also important to keep in mind: Just because a product is natural doesn’t mean it’s safe. In fact, there are certain herbs that are known to be dangerous during pregnancy (and that might be lurking in herbal remedies without you even knowing). For instance, aloe, barberry, black cohosh, blue cohosh, dong quai, feverfew, goldenseal, juniper, and wild yam are uterine stimulants and could potentially lead to miscarriage or premature contractions.

How much more food?

But it’s important to remember that one of the two is a tiny developing fetus whose caloric needs are significantly lower than mom’s—a mere 300 on average a day… So, on average, you now need only about 300 calories more a day than you used to eat pre-pregnancy—the equivalent of 2 glasses of skim milk and a bowl of oatmeal.

DHA

Omega-3 fatty acids, most notably DHA, are the best addition you can make to your diet when you’re eating for two. That’s because DHA is essential for proper brain growth and eye development in fetuses and young babies. In fact, researchers have found that toddlers whose moms consumed plenty of DHA during pregnancy had better hand-eye coordination than their peers, though it’s unclear if this translates to boosted brainpower later in childhood.

Not too much Vitamin A

No more than 4,000 IU (800 mcg) of vitamin A (amounts over 10,000 IU could be toxic). Many manufacturers have reduced the amount of vitamin A in their vitamin supplements or have replaced it with beta-carotene, a much safer source of vitamin A.

Fish

Choose from salmon (wild caught is best), sole, flounder, haddock, trout, halibut, ocean perch, pollack, cod, light canned tuna, catfish, and other smaller ocean fish (anchovies, sardines, and herring are not only safe, but also loaded with omega-3s).

Fermented food

Are you sweet on sauerkraut, crazy for kimchi, and nutty for natto? Old favorites in many cultures, fermented foods like these (and many others, including yogurt, kefir, tempeh, and miso, to name a few) are new again—and they’re hitting the shelves with lots of health claims, too.

Healthy weight gain

If your BMI is average (between 18.5 and 25), you’ll probably be advised to gain between 12kg to 15kg, the standard recommendation for the average-weight pregnant woman.

Eat a variety of food to avoid picky kids later!

now that your baby is swallowing amniotic fluid each day (for hydration, nutrition, and also to get practice swallowing and digesting), he or she will be getting a virtual taste of—and a taste for—whatever’s on your menu.

Morning sickness

Food to combat morning sickness

Good choices include ginger ale, soothing smoothies, and crackers (but ask first—what spells r-e-l-i-e-f for one queasy woman spells v-o-m-i-t for another). Encourage her to eat small meals throughout the day instead of 3 large ones (spreading out the load and keeping her tummy filled may ease her nausea),

Yes, you can eat peanuts and dairy

Good news: The latest research suggests that eating peanuts while pregnant not only doesn’t trigger peanut and other allergies in babies-to-be, but it may actually prevent them. So as long as you’re not personally allergic to peanuts, there’s no need to skip the Skippy—and maybe more reason than ever to reach for it. Ditto for dairy products or other highly allergenic foods. If you’re not allergic to them yourself (in which case you’d clearly want to steer clear), there’s no reason to avoid any allergenic foods during pregnancy.

Other practices

Exposure to sun

While the body produces vitamin D when exposed to sunlight, making enough can be challenging—especially for those who have darker skin, live in less-sunny climates, don’t get outdoors enough, or wear sunscreen.

Wear supportive bra

Sagging results not just from pregnancy itself but from a lack of support during pregnancy. No matter how perky your breasts are now, protect them from a floppy future by wearing a supportive bra (though in that tender first trimester, you may want to avoid restrictive underwires).

How to combat stretch marks

You might be able to minimize, if not prevent, stretch marks by keeping weight gain steady, gradual, and moderate (the faster skin stretches, the more likely the stretching is to leave its mark)… And though no topical preparation has been proven to prevent stretch marks from zigzagging their way across your skin, there’s no harm in applying pregnancy-safe moisturizers, such as cocoa or shea butter.

Always empty your bladder!

Don’t hold it in. Emptying your bladder as needed (but at least every 2 hours) also helps prevent UTIs (Urinary Track Infections). A good strategy: Plan to pee every hour or so, whether you need to or not.

Why hair and nails’ growth rate will be higher

those same hormones are actually responsible for a substantial pregnancy perk: nails that grow faster than you can manicure them and hair that grows before you can secure appointments with your stylist (and if you’re really lucky, hair that is thicker and more lustrous). Those pregnancy hormones trigger a surge in circulation and a boost in metabolism that nourish hair and nail cells, making them healthier than ever before.

Complications

placenta previa

Another reason not to worry: If you do end up being diagnosed with placenta previa, your baby will simply be delivered via a scheduled cesarean.

Group B strep (GBS)

Group B strep (GBS) is a strain of bacteria that lives quietly in the vaginas of between 10 and 35 percent of healthy women—which makes them “carriers” of GBS (or GBS-positive)… And that’s why expectant moms are routinely tested for GBS—usually between 35 and 37 weeks (testing before 35 weeks isn’t accurate in predicting who will be carrying GBS at the time of delivery).

HG

What is it? Hyperemesis gravidarum (HG) is the medical term for severe pregnancy nausea and vomiting that is continuous and debilitating (not to be confused with typical morning sickness, even a pretty bad case). HG begins early in the first trimester (with a diagnosis usually coming about 9 weeks into pregnancy) and usually starts to lift between weeks 12 and 16.

1st trimester

Mild period like cramp

Don’t worry. A feeling of pressure or even mild crampiness without bleeding is very common, especially in first pregnancies—and is usually a sign that everything’s going right, not that something’s going wrong.

Spotting

So if you’re noticing only light spotting—similar to what you see at the beginning or end of your period—you can take a deep breath and read on for a probable (and probably reassuring) explanation. Such light spotting is usually caused by one of the following: Implantation of the embryo.

Common to have indigestion

It’s nearly impossible to have an indigestion-free 9 months—tummy troubles come with the pregnant territory.

Prominent veins

Not only are these veins (which can make your chest and belly look like a road map) normal and nothing to worry about, but they are a sign that your body is doing what it should. They’re part of the network of veins that has expanded to carry the increased blood supply of pregnancy, which will be nourishing your baby.

Bloaty Gassy Clogged up

Irregularity—that bloated, gassy, clogged-up feeling—is a very regular pregnancy complaint. And there are good reasons why. For one, the high levels of progesterone circulating in your expectant system cause the smooth muscles of the large bowel to relax, making them sluggish and allowing food to hang around longer in the digestive tract.

2nd trimester

Vaginal discharge is normal

A thin, milky, mild-smelling discharge (known in the ob business as leukorrhea) is normal throughout pregnancy. Its purpose is noble: to protect the birth canal from infection and maintain a healthy balance of bacteria in the vagina.

Fetal kicks are normal

After the 28th week, fetal movements become more consistent, and it’s a good idea to get into the habit of checking on your baby’s activity daily.

3rd trimester

Baby’s head acts like a cork

If you do end up being among the 15 percent who spring a prelabor leak, you’ll probably notice the tell-tale gush or trickle more if you’re lying down than if you’re standing up. That’s because when you’re upright (standing, walking, even sitting), your baby’s head acts like a cork in a bottle, blocking the opening of the uterus and keeping most of the amniotic fluid in.

Place something while sleeping

You also might want to place heavy towels, a plastic sheet, or hospital bed pads under your sheets in the last few weeks, just in case your water breaks in the middle of the night.

Normal amount of kicks

Ten or more movements during each 1 to 2 hour test period (squirms and wriggles count, but not hiccups) mean that your baby’s activity level is normal.

Labour and childbirth

Epidural

Epidural. A full two-thirds of women delivering at hospitals choose to relieve their labor pain with an epidural. Why do so many laboring moms request the epidural by name? For one, it’s an extremely safe way to net good pain relief—only a small amount of medication is needed to achieve the desired effect, and the drug barely reaches the bloodstream

Cons of anesthesia

The major downside to general anesthesia (besides the fact that mom has to miss the birth) is that it sedates the baby along with the mother. The medical team will minimize those sedative effects by administering the anesthesia as close to the actual birth as possible. That way the baby can be delivered before the anesthetic has reached him or her in amounts large enough to have an effect.

Don’t worry about poop and pee

Involuntary pooping (or peeing) is experienced by nearly everyone during delivery. No one else in the room will think twice about it, and neither should you (you probably won’t even notice it). Pads will immediately whisk away anything that comes out.

Skin contact

In case you need a reason to do that, studies show that infants who have skin-to-skin contact with their mothers just after delivery sleep longer and are calmer hours later.

Rooming-in

Wondering where all the babies at your local hospital went (you know, the neatly wrapped bundles that used to be on display in the nursery, in row after row of bassinets)? They’re rooming-in with their moms, most likely. Full-time rooming-in has become the standard in family-centered maternity care, and for a lot of very sound reasons.

After the birth

Vaginal flow for the next few weeks

Maxipads, not tampons, should be used to absorb the flow, which may continue on and off for just a couple of weeks or for as long as 6 weeks.

  • Preterm. A baby born between 20 weeks and 37 weeks is considered preterm.
  • Early Term. If your baby is born between 37 weeks 0 days and 38 weeks 6 days
  • Full Term. Babies born between 39 weeks 0 days and 40 weeks 6 days
  • Late Term. Arrival at between 41 weeks 0 days and 41 weeks 6 days.
  • Post-term. Babies born after 42 weeks 0 days.

Breastfeeding

Finally, if you’re planning to breastfeed, try to get started as soon as possible after birth (ideally within 30 minutes) and feed every 2 to 3 hours to prevent hypoglycemia (low blood sugar). To play it safe, babies of diabetic moms are usually not discharged from the hospital until they are maintaining blood glucose levels and feeding well.

Possibility of donating the umbilical cord?

First, know that the decision you’ve made might save a life someday. Cord blood contains stem cells that can treat a host of diseases, and most major medical organizations (including the AAP) encourage public donation of umbilical-cord blood cells so they can be used for actual transplants or for valuable medical research—a far better option than letting that precious cord blood be thrown away.

Don’t try to be a supermom and be a hero

If baby, spouse, and job are priorities, perhaps keeping the house clean will have to take a (messy) backseat. Maybe home cooked will sometimes give way to home delivered, or the laundry basket will become someone else’s responsibility.

Take it easy

The truth is, giving birth makes you a mother, but it doesn’t necessarily make you feel like one. Only time spent on this sometimes bewildering, sometimes overwhelming, always amazing job will do that. The day-to-day (and night-to-night) of parenting is never easy, but it absolutely, positively gets easier.

And babies doesn’t judge your mistakes

Best of all, since your baby’s never had another mom (or dad) to compare you with, you definitely stack up really well in his book. In fact, you’re the best he’s ever had.

Why hair fall will increase after giving birth

Ordinarily, the average head sheds 100 hairs a day (just not all at once, so you don’t usually notice the shedding), and those hairs are being continually replaced. During pregnancy, however, hormonal changes keep those hairs from falling out, which means your head hangs on to them.

Breastfeeding

Nutrition in breast milk

It’s custom made. Tailored to meet the nutritional needs of human infants, breast milk contains at least 100 ingredients that aren’t found in cow’s milk and that can’t be precisely replicated in commercial formulas. And unlike formula, the composition of breast milk changes constantly to meet a baby’s ever-changing needs: It’s different in the morning than it is in the late afternoon, different at the beginning of a feeding than at the end, different the 1st month than the 7th, and different for a preemie than for a full-term newborn.

It’s a brain booster. Breastfeeding, according to some evidence, appears to slightly increase a child’s IQ, at least through age 15, and possibly beyond. This may be related not only to the brain-building fatty acids (DHA) in breast milk, but also to the closeness and mother-baby interaction that is built into breastfeeding, which is believed to nurture a newborn’s intellectual development.

Colostrum

Colostrum. You already have this thick clearish-yellow premilk at the ready as soon as baby is born—providing your cuddly cutie with crucial antibodies and just the right kind of nourishment for the first few days of life.

Feeding schedule

Feed around the clock. Aim for a feeding every 2 to 3 hours, timed from the beginning of one to the beginning of the next—for a total of 8 to 12 feeds per day.