Pregnancy For Dummies

Dr Sarah Jarvis has been a GP for 20 years. She is the resident doctor on the BBC's The One Show, and a regular columnist for Good Housekeeping and My Weekly. Dr Roger Henderson has also been a GP for 20 years, and writes for The Sunday Times and the Sunday Mirror. He is also the medical consultant to the health website NetDoctor. Joanne Stone, MD, and Keith Eddleman, MD, are obstetrician-gynaecologists. Mary Duenwald is a veteran journalist.

Introduction 1

About This Book 1

Conventions Used in This Book 2

What You’re Not to Read 2

Foolish Assumptions 3

How This Book Is Organised 3

Part I: The Game Plan 3

Part II: Pregnancy: A Drama in Three Acts 4

Part III: The Big Event: Labour, Delivery and Recovery 4

Part IV: Special Concerns 4

Part V: The Part of Tens 4

Appendix 5

Icons Used in This Book 5

Where to Go from Here 6

Part I: The Game Plan 7

Chapter 1: From Here to Maternity 9

Getting Ready to Get Pregnant: The Preconception Visit 9

Taking a look at your history 10

Evaluating your current health 11

Answering Commonly Asked Questions 12

Getting to your ideal body weight 12

Reviewing your medications 13

Considering herbal remedies and vitamin supplements 15

Recognising the importance of vaccinations and immunity 16

Quitting contraception 18

Introducing Sperm to Egg: Timing Is Everything 19

Pinpointing ovulation 20

Taking an effective (and fun) approach 21

Chapter 2: I Think I’m Pregnant! 23

Recognising the Signs of Pregnancy 23

Testing, Testing, 1, 2, 3 24

Getting an answer at home 24

Going to your GP for answers 25

Antenatal and Labour Care – What’s Available? 25

Where to have your baby 25

Looking at your options: Private or NHS? 27

Who’s Who? The Varying Roles of Health Care Professionals 28

Your GP 28

Your midwife 29

Independent midwives 29

Your obstetrician 29

Maternal-foetal medicine specialists 30

Your paediatrician 30

Your health visitor 30

Chapter 3: Preparing for Life during Pregnancy 31

Working Out Your Due Date 32

Planning Antenatal Visits 33

Preparing for Physical Changes 36

Spotting breast and bladder changes 36

Coping with mood swings 36

Living through leg cramps 37

Noticing vaginal discharge 37

Putting up with backaches 38

Handling stress.38

Understanding the Effects of Medications, Alcohol and Drugs on Your Baby 39

Taking medications 39

Smoking 40

Drinking alcohol 41

Using recreational/illicit drugs.41

Looking at Lifestyle Changes 43

Pampering yourself with beauty treatments 43

Relaxing (or not) in hot tubs, saunas or steam rooms 44

Travelling 45

Getting dental care 46

Having sex 47

Working during Pregnancy: A Different Type of Labour 48

Chapter 4: Checking Out Your Rights and Welfare Benefits 51

Your Rights When You’re Having a Baby 52

Discrimination against pregnant women 52

Ordinary and additional maternity leave 52

Financial Benefits during Pregnancy 53

Statutory Maternity Pay 54

Maternity allowances 54

Sure Start Maternity Grants 55

You and your Mat B1 55

Entitlements as a New Parent 55

Child Benefit 55

Working Tax Credit 56

Child Tax Credit 56

Statutory Paternity Pay 56

Chapter 5: Diet and Exercise for the Expectant Mother 57

Looking at Healthy Weight Gain 57

Determining how much is enough 58

Avoiding weight obsession 59

Understanding your baby’s weight gain 60

Taking Stock of What You’re Taking In 61

Using a healthy eating pyramid 61

Supplementing your diet 63

Determining Which Foods Are Safe 65

Debunking popular food myths 65

Identifying potentially harmful foods 65

Considering Special Dietary Needs 68

Eating right, vegetarian-style 68

Combating constipation 68

Dealing with diabetes 69

Working Out for Two 69

Adapting to your body’s changes 70

Exercising without overdoing it 71

Comparing forms of exercise 72

Part II: Pregnancy: A Drama in Three Acts 75

Chapter 6: The First Trimester 77

A New Life Takes Shape 77

Adapting to Pregnancy: Body Changes in the First Trimester 80

Breast changes 81

Fatigue 81

Any-time-of-day sickness 82

Bloating 83

Frequent urination 84

Headaches.84

Constipation 85

Cramps 85

Booking Baby In: Your First Antenatal Appointments 86

Understanding the consultation 86

Considering the physical examination 90

Looking at standard tests 90

Your booking appointment – now it’s your turn! 93

Recognising Causes for Concern 94

Bleeding.94

Miscarriage 95

Ectopic pregnancy 97

Chapter 7: The Second Trimester 99

Discovering How Your Baby Is Developing 99

Understanding Your Changing Body 101

Forgetfulness and clumsiness 102

Wind 102

Hair and nail growth 102

Heartburn 103

Lower abdominal/groin pain 103

Nasal congestion 105

Nosebleeds and bleeding gums 105

Skin changes 105

Checking In: Antenatal Visits 107

Recognising Causes for Concern 107

Bleeding 107

Foetal abnormality 108

Incompetent cervix 108

Identifying other potential problems 109

Chapter 8: The Third Trimester 111

Your Baby Gets Ready for Birth 111

Movin’ and shakin’: Foetal movements 113

Flexing the breathing muscles 113

Hiccupping in utero 114

Keeping Up with Your Changing Body 114

Accidents and falls 114

Braxton-Hicks contractions 114

Carpal tunnel syndrome 116

Fatigue 116

Piles 117

Insomnia 118

Feeling the baby engage 118

Pregnancy rashes and itches 119

Preparing for breast-feeding 120

Sciatica 121

Shortness of breath 121

Stretch marks 121

Swelling 122

Urinary stress incontinence 122

Varicose veins 123

Thinking about Labour 123

Writing a birth plan 124

Timing labour 124

Using perineal massage 125

Hitting the Home Stretch: Antenatal Visits in the Third Trimester 125

Preparation for Parenthood Classes 126

Recognising Causes for Concern 126

Bleeding.127

Breech presentation 127

Decreased amniotic fluid volume 128

Decreased foetal movement 128

Foetal growth problems 128

Leaking amniotic fluid 129

Pre-eclampsia 130

Preterm labour 130

When the baby is late 130

Getting Ready to Head to the Hospital 131

Packing your suitcase131

Choosing – and using – a car seat 132

Chapter 9: Understanding Antenatal Testing 135

Non-Invasive (Screening) Tests 136

Screening for alpha-foetoprotein 136

Screening for Down’s syndrome 137

Screening with ultrasound scans 138

Understanding screening accuracy 139

Invasive Tests for Foetal Abnormalities 140

Amniocentesis 141

Chorionic villus sampling 144

Other Antenatal Tests and Procedures 145

Foetal echocardiogram 145

Doppler studies 145

Cardiotocography 145

Doppler velocimetry 146

Foetal blood sampling 146

Part III: The Big Event: Labour, Delivery and Recovery 147

Chapter 10: I Think I’m in Labour!      149

Knowing When Labour Is Real – and When It Isn’t 149

Noticing changes before labour begins 150

Telling false labour from true labour 151

Deciding when to call the labour ward or your practitioner 152

Checking for labour with an internal examination 153

Getting Admitted to the Hospital 154

Monitoring Your Baby 155

Foetal heart monitoring 155

Other tests of foetal health 156

Nudging Things Along: Labour Induction 156

Inducing labour 158

Augmenting labour 158

Getting the Big Picture: Stages and Characteristics of Labour 159

The fi rst stage 159

The second stage 162

The third stage 162

Handling Labour Pain 163

Breathing exercises 163

TENS 164

Gas and air 164

Pethidine and meptid 164

Epidural 164

General anaesthetic 166

Considering Alternative Birthing Methods 166

Delivering without drugs – natural childbirth 166

Giving birth at home 167

Immersing yourself in a water birth 167

Chapter 11: Special Delivery: Bringing Your Baby into the World   169

Having a Vaginal Delivery 169

Pushing the baby out 171

Getting an episiotomy 173

Handling prolonged second-stage labour 175

The big moment: Delivering your baby 175

Delivering the placenta 176

Repairing your perineum 176

Assisting Nature: Operative Vaginal Delivery 177

Having a Caesarean Delivery 178

Understanding anaesthetics 179

Looking at reasons for caesarean delivery 180

Recovering from a caesarean delivery 181

Congratulations! You Did It! 182

Shaking after delivery 182

Understanding postpartum bleeding 182

Hearing your baby’s first cry 183

Cutting the cord 183

Checking your baby’s condition 183

Chapter 12: Hello, World! Your Newborn 185

Looking at Your Bundle of Joy – Goo, Blotches and All 185

Vernix caseosa 186

Caput and moulding 186

Black-and-blue marks 187

Blotches, patches and more 187

Baby hair 188

Extremities 188

Eyes and ears189

Genitalia and breasts 189

Umbilical cord 190

Newborn size 190

Baby begins to breathe 190

Knowing What to Expect in the Hospital 191

Preparing baby for life outside the womb 191

Understanding baby’s developing digestive system 192

Considering circumcision 192

Spending time in the neonatal intensive care unit 193

Checking In: Baby’s First Doctor’s Visit 194

Considering heart rate and circulatory changes 194

Looking at weight changes 195

Bringing Baby Home 195

Settling Baby in at Home 196

Bathing 196

Burping 197

Sleeping and sudden infant death syndrome (SIDS) 198

Crying 199

C is for colic 200

Newborn jaundice 200

Dummies (For Dummies) 201

Preventing newborn injuries 201

Shopping for the baby 201

Registering Your Baby’s Birth 202

Recognising Causes for Concern 203

Chapter 13: Taking Care of Yourself after Delivery 205

Recuperating from Delivery 206

Looking and feeling like a new mum206

Understanding postnatal bleeding 206

Dealing with perineal pain 207

Surviving swelling 209

Coping with your bladder 209

Battling the haemorrhoid blues 210

Understanding postnatal bowel function 210

Continuing to recover at home 211

Recovering from a Caesarean Delivery 211

Going to the recovery room 211

Taking it one step at a time 212

Understanding post-caesarean pain 213

Dealing with post-op pain 214

Getting ready to go home 214

Continuing to recover at home 214

The Party’s Not Over: More Postnatal Changes 216

Sweating like a new mum 216

Dealing with breast engorgement 217

Understanding hair loss 217

Chasing away the baby blues 217

Recognising postnatal depression 219

Returning to ‘Normal’ Life 220

Getting fi t all over again 220

Losing the weight 221

Pondering your postnatal diet 222

Doing pelvic floor exercises 223

Having sex again 223

Choosing contraception 224

Chapter 14 : Feeding Your Baby 225

Deciding between Breast and Bottle 225

Considering the advantages of breast-feeding 226

Checking out the benefits of bottle-feeding 227

Latching onto Breast-feeding 228

Looking at the mechanics of lactation 229

Checking out breast-feeding positions 230

Getting baby to latch on 230

Orchestrating feedings 232

Maintaining your diet 234

Looking at options for contraception 235

Determining which medications are safe 235

Handling common problems 235

Bottle-feeding for Beginners 239

Stopping milk production 239

Choosing the best bottles and nipples 239

Feeding your baby from a bottle 240

Dealing with Baby’s Developing Digestive System 242

Part IV: Special Concerns 245

Chapter 15: Pregnancies with Special Considerations 247

Figuring Out How Age Matters 247

Over-35 (or older) mums 247

Not-so-young dads 248

Very young mums 250

Having Twins or More 250

Looking at types of multiples 251

Determining whether multiples are identical or fraternal 251

Down’s syndrome screening in pregnancies with twins or more 252

Genetic testing in pregnancies with twins or more 252

Keeping track of which baby is which 253

Living day-to-day during a multiple pregnancy 254

Going through labour and delivery with twins 255

Covering special issues for mums with multiples 256

Getting Pregnant Again 259

Realising how each pregnancy is different 260

Giving birth after a prior caesarean delivery 261

Preparing Your Child (or Children) for a New Arrival 262

Explaining pregnancy 263

Making baby-sitting arrangements for your delivery 264

Coming home 264

Chapter 16: When Things Get Complicated 267

Dealing with Preterm Labour 267

Checking for signs of preterm labour269

Stopping preterm labour 269

Preventing preterm labour 269

Delivering the baby early 270

Handling Pre-eclampsia 270

Understanding Placental Conditions 271

Placenta praevia 272

Placental abruption 273

Recognising Problems with the Amniotic Fluid and Sac 274

Too much amniotic fluid 274

Too little amniotic fluid 275

Rupture of the amniotic sac 275

Describing Problems with Foetal Growth 276

Smaller-than-average babies 277

Larger-than-average babies 278

Looking at Blood Incompatibilities 279

Dealing with Breech Presentation 280

Pondering Post-Date Pregnancy 281

Chapter 17: Pregnancy in Sickness and in Health 283

Getting an Infection during Pregnancy 283

Bladder and kidney infections 283

Chickenpox 285

The common cold 286

German measles (rubella) 287

Herpes infections 287

Human immunodeficiency virus (HIV) 287

Tummy bugs (gastroenteritis) 288

Vaginal infections.288

Handling Pre-Pregnancy Conditions 289

Asthma 289

Chronic hypertension 290

Deep-vein thrombosis and pulmonary embolus 290

Diabetes 291

Fibroids 293

Seizure disorders (epilepsy) 293

Thyroid problems 294

Chapter 18: Coping with the Unexpected 297

Surviving Recurrent Miscarriages 297

Coping with Late-Pregnancy Loss 299

Dealing with Foetal Abnormalities 299

Finding Help 300

Beginning to Heal 301

Part V: The Part of Tens 303

Chapter 19: Ten Things Nobody Tells You 305

Pregnancy Lasts Longer than Nine Months 305

Other People Can Drive You Crazy 306

You Feel Exhausted in the First Trimester 306

Round Ligament Pain Really Hurts 306

Your Belly Becomes a Hand Magnet 307

Piles Are a Royal Pain in the . . . 307

Sometimes Women Poo While Pushing 307

The Weight Stays On after the Baby Comes Out 308

Hospital Towels are Relics from Your Mother’s Era 308

Breast Engorgement Really Sucks 308

Chapter 20: Ten (Or So) Old Wives’ Tales 309

The Old Heartburn Myth 309

The Mysterious Umbilical Cord Movement Myth 309

The Curse Myth 310

The Heart Rate Myth 310

The Ugly Stick Myth 310

The Coffee Myth 310

The Myth of International Cuisine 310

The Great Sex Myth 311

The Round Face Myth 311

The Ring Myth 311

The Moon Maid Myth 312

The Belly Shape Myth 312

The Ultrasound Tells All Myth 312

Chapter 21: Ten Landmarks in Foetal Development 313

The Baby Is Conceived 313

The Embryo Implants Itself 313

The Heart Begins Beating 314

The Neural Tube Closes 314

The Face Develops 314

The Embryonic Period Ends 314

The Sexual Organs Appear 314

Quickening Occurs 315

The Lungs Reach Maturity 315

A Baby Is Born 315

Chapter 22: Ten Key Things You Can See on Ultrasound 317

Measurement of Crown-Rump Length 317

The Face 318

The Spine 319

The Heart 319

The Hands 320

The Foot 321

The Foetal Profile 321

The Stomach 322

It’s a Boy! 322

It’s a Girl! 323

Appendix: The Pregnant Man: Having a Baby from a Dad’s Perspective  325

Reacting to the News 325

Knowing What to Expect from the First Trimester 326

Watching Mum Grow – the Second Trimester 327

Under Starter’s Orders – the Third Trimester 327

Dad in the Delivery Room 328

Home at Last – with Your New Family 330

Index 331