Your Pregnancy Step By Step

Month One of Your Pregnancy

 

Baby And Body Changes

During the first trimester of pregnancy, which lasts approximately fourteen weeks from the first day of your last menstrual period, your body is hard at work forming one of the most intricate and complex works of nature. By the end of your first official month of pregnancy (six weeks after your last menstrual period, but four weeks since conception), your developing child will have grown an astonishing 10,000 times in size.
 
Month One Checklist
  • Evaluate your doctor, midwife, or group practice and decide if it's right for you and your pregnancy.
  • Discuss any possible on=the-job-hazards with your doctor or midwife.
  • Evaluate your diet and begin taking prenatal vitamins if recommended by your doctor or midwife.
  • Get up to speed on your health insurance coverage for prenatal visits, delivery, and the care of your child.
  • If you smoke or drink, quit now.
  • Prepare a budget to save for when your baby arrives.
 
Your Baby This Month

Making its longest journey until the big move nine months from now, your developing baby (called a zygote, or fertilized ovum) travels from the fallopian tube and into the uterus (or womb). By day four, the zygote has formed a small solid cluster of cells known as a morula.

By day five or six, the morula grows to a blastocyst. Within days, the blastocyst nestles into the nutrient-rich lining of your uterus (the endometrium) as implantation begins. About fifteen days after conception, the blastocyst becomes an embryo. Next to the embryo floats the yolk sac, a cluster of blood vessels that provide blood for the embryo at this early stage until the placenta takes over.

As month one draws to a close, your baby's heart is beating, lung buds have appeared, and construction of the gastrointestinal system and liver are underway. The neural tube, the basis of the baby's central nervous system, has developed and the forebrain, midbrain, and hindbrain are defined. He (or she) is starting to look more like a person, too. Arm and leg buds-complete with the beginnings of both feet and hands-are visible. It's an amazing list of accomplishments considering your baby is about the size of a raisin, less than ¾ inch long.
 
Your Body's Changes

At this point in your pregnancy, you might not notice any significant changes in shape and size. You may feel some of the following changes, though. Note which you are experiencing so you can look back on the progress of your pregnancy and discuss any concerns you have with your healthcare provider.

You feel slightly bloated, and your waistband begins to feel a bit snug.
Your breasts are starting to increase in size.
The areolas around your nipples enlarge and darken.
Your breasts are more tender.
Vaginal secretions increase, similar to those you get premenstrually.
You may feel tired and run down. Grab a nap during the day or make an early bedtime a priority.
You may feel faint or dizzy. Sit or lay down on your side as soon as possible. Try not to lay flat on your back as this can make the dizziness worse.
 
On Your Mind

Pregnancy is a time of great anticipation as you head out into uncharted waters. Worries about the baby's health and the possibility of miscarriage are common fears early in pregnancy. Although it may be easier said than done, letting go of your anxieties, at least for a little while, is the best thing for you and your baby right now.

Here are some ways to deal with anxiety about miscarriage and stress about the pregnancy:

  • Designate a certain area of your home, like your bedroom, a worry-free zone, and then stick to a vow to let your anxieties go when you are in that space.
  • Use an aromatherapy candle you like to help you relax.
  • Play soft music or nature sounds.
  • Incorporate soothing scenery in the form of photographs and posters to relieve your anxiety.
 
 
Month Two of Your Pregnancy
 
You've made it into month two, or weeks six through ten, of your pregnancy. By the end of this month, your baby will have outgrown her embryonic development and matured into a fetus. Your body is changing rapidly. You may start to feel pregnant now, if you didn't feel so before.
 
Month Two Checklist
  • Start developing a maternity wardrobe.
  • Make room for your baby.
  • Create a baby safe car environment.

  •  

  • Your Baby This Month

Your unborn child has now advanced from raisin to raspberry size, about a half inch in length. By the end of the month, she will be about an inch long. Your baby is lengthening and straightening from the curled form she held last month. The tail she was sporting disappears around week eight, and her closed eyes start to move from the sides of her head to their permanent location. The face is further defined by a nose an jaw, and the buds of twenty tiny baby teeth are present in the gums by week ten. The palate and vocal cords also form around this time. Important organ systems are nearly complete by the end of this second month. The right and left hemispheres of your baby's brain are fully formed, and brain cell mass grows rapidly. Soft bones begin to develop, and the liver starts to manufacture red blood cells until the bone marrow can take over the job in the third trimester.
 
Your Body's Changes
Check off which of the following symptoms you experience this month to look back on the progress of your pregnancy and talk to your doctor or midwife about any that make you especially uncomfortable:

Frequent urination
Tender, larger breasts
Increased vaginal discharge
Occasional dizziness or faintness
Indigestion or gas
Headaches
Nasal congestion and/or runny nose
Increased saliva

 

On Your Mind

Now that you're feeling more symptoms of pregnancy, the reality of impending parenthood may suddenly hit home. Understanding and recognizing your emotional changes can help you better control your stress levels and mood swings.

It's easy to get stressed out over what may seem like an overwhelming amount of preparation for your new family member. Your body is already working overtime on the development of your child; try to keep your commitments and activities at a reasonable level to prevent mental and physical overload.
As you rush to get everything just so, remember that your little one is not going to care if the crib matches the dresser, but he will feel the effects of your excess tension. Take steps to decompress when you do feel the pressure building by practicing relaxation and meditation techniques e.g., progressive muscle relaxation, yoga with your doctor's consent, adjustments to your work or social schedule, or carving out an hour of me time each evening to decompress.

 

At the Doctor's or Midwife's Office

If you had your preliminary appointment last month, your prenatal office visits will now start to slip into a routine. At the start of each appointment, expect to:

  • Step on the scale
  • Give a urine sample
  • Have your blood pressure checked
  • Be asked about any new or continuing pregnancy symptoms
  • Have your provider feel the outside of your abdomen
Bring along that list of questions that have come up since your last visit. Write these down at the conclusion of each chapter when they come to you and your partner so they are easy to find and you won't have to rely on your memory at the office.
 
 
Month Three of Your Pregnancy
 
This is a landmark month as you finish up your first trimester! By the end of this month, your baby will grow to more than three inches in length and almost one ounce, about the size and heft of a roll of Life Savers. His head accounts for one-third of his total length, and his tongue, salivary glands, and taste buds have formed. You make first contact this month as you hear his heartbeat and perhaps even see him on ultrasound.
 
Month Three Checklist
  • Create ways to compensate for forgetfulness.
  • Make sleep a priority; set a new early bedtime and stick to it.
     
    Your Baby This Month

    Your  baby's heart is pumping about twenty-five quarts of blood each day, and a lattice of blood vessels can be seen through his translucent skin, which is starting to develop a coat of fine downy hair called lanugo. His, or her, gender is apparent since the external sex organs have now fully differentiated, but it will take a combination of luck and technical skill for an ultrasound operator to reveal if you have a son or daughter.

    Your Body's Changes
    This month, you start to sport a protruding belly, which may mean sharing your news with friends, family, and coworkers if you haven't already. Your uterus is about the size of a softball and stretches to just about your pubic bone. Two to four pounds of total weight gain is about average for the first trimester; if you've been down and out with nausea and vomiting, you may be below the curve. Weight gain will pick up in the second trimester and peak in the third as your baby starts to fill out your womb.
  •  

    While twenty-five to thirty-five pounds is the average suggested total weight gain for a pregnancy, your height and build will influence that number. Underweight women and women with multiple pregnancies, twins or more, will be expected to gain more, overweight women will be encouraged to gain slightly less.

    Focus on the quality of food you're eating and on getting some regular exercise, cleared with your provider first.
 
Where the Weight Goes
  • Baby 7.5 to 8.5 pounds
    Uterus 2 to 2.5 pounds
    Placenta 1.5 to 2 pounds
    Amniotic fluid 2 pounds
    Blood 3 to 4 pounds
    Breasts 1 to 2 pounds
    Maternal fat and nutrient stores 4 to 6 pounds
    Retained maternal fluids 4 to 8 pounds
    Total 25 to 35 pounds

     

    Although nausea and vomiting may finally be waning, constipation, gas, and occasional heartburn may take over as the gastrointestinal pests of the second trimester.
  •  
    Constipation can be caused by an increase in progesterone, which can act to slow down the digestive system.  Later in the pregnancy, pressure on the intestines caused by your growing uterus adds to the problem.  Iron supplements or prenatal vitamins with added iron can also cause constipation, so talking to your provider about the possibility of a dosage adjustment or an extended release formula may be in order.  An increase in dietary fiber, plenty of water intake, and exercise as approved by your healthcare provider may also help to get things going again. Be sure to consult your doctor before taking any stool softeners or laxatives.
  •  
    Other pregnancy symptoms that may continue or begin this month include the following. Check off symptoms you experience this month and talk to your doctor or midwife about any that make you especially uncomfortable:
  •  

    Fatigue
    Frequent urination
    Tender breasts
    Occasional dizziness or faintness
    Headaches
    Nasal congestion and/or runny nose
    Increased saliva
    Nausea

    On Your Mind

    Like any mum-to-be, you've got a lot on your mind. That alone may have you forgetting what used to be second nature and misplacing things. Pregnancy hormones, sleep deprivation, and stress have all been suggested as possible culprits.
     
  • Whatever the cause, forgetting appointments and misplacing things can leave you feeling muddled and helpless. To cope with forgetfulness, try the following.
    • Writing notes
    • Sticking to a routine (e.g., car keys always go into a basket by the door)
    • Living by a written or electronic organizer
    • Requesting a twenty-four-hour advance phone call reminder when you schedule appointments such as in-home appliance repair or a hair cut.

       

      At the Doctor's or Midwife's Office

      This month, your provider may:

      • Order an ultrasound to see your baby
      • Start estimating the size of your baby by counting the centimeters from your pubic bone to the tip of your fundus—the top of the uterus, Some practitioners do not take the fundal height until after week twelve or even week twenty.
      • Tell you about the alpha-fetoprotein test. The AFP is typically given at sixteen to eighteen weeks, and it tests for the possibility of neural tube defects and/or chromosomal abnormalities. Since it is optional, many providers give an informational sheet to patients so they may consider whether they want to take it.
      • Check for the fetal heartbeat using a small ultrasound device called a Doppler or Doptone. 
         
         
        Month Four of Your Pregnancy
         
        Welcome to the second trimester, or what many women consider the fun part. Your energy is up, and your meals are staying down. You and your baby are headed into a period of rapid growth now, so hang on and enjoy the ride.
         
        Month Four Checklist
        • Treat yourself to a special day out.
        • Begin keeping a food log.
        • If you don't have one, shop for a crib that meets current safety standards.
        • Create a prenatal exercise routine.
           
          Your Baby This Month

          Snoozing, stretching, swallowing, and even thumb-sucking, your baby is busy this month as she tests out her new reflexes and abilities. She is losing her top-heavy look as her height starts to catch up to her head size. By the end of this month, she will measure about six to eight inches in length and weigh approximately six ounces.

          Your Body's Changes
          If you weren't showing last month, chances are you will have a definite pregnant profile by the end of this month. Your uterus is about the size of a head of cabbage, and its top lies just below your belly button.
           
        • Your appetite may start to pick up this month, especially if you've been too sick to enjoy a good meal until now. About 60 percent of your total pregnancy weight, about eleven to fifteen pounds, will be gained in this trimester.
        •  

          Heartburn may start to become a persistent problem as your uterus crowds your stomach and the smooth muscles of your digestive tract remain relaxed from the hormone progesterone. Some tips for putting out the fire include:

          • Avoid greasy, fatty, and spicy foods.
          • Stay away from alcohol and caffeinated drinks, these may relax the valve between the stomach and the esophagus and exacerbate heartburn.
          • Eat smaller, more frequent meals instead of three large ones.
          • Drink plenty of water between meals to reduce stomach acid.
          • Don't eat just before you go to bed or lay down to rest.
          • Pile a few extra pillows on the bed to assist gravity in easing heartburn while you sleep.
          •  
          Another option you have is to keep a food log to try to determine what your heartburn triggers are.
        •  

          Other symptoms of second-trimester pregnancy you may start or continue to experience this month include the following. Check off those that you are experiencing so that you may discuss relief with your doctor:

          Hemorrhoids
          Nausea
          Fatigue
          Frequent urination
          Tender and/or swollen breasts
          Bleeding gums
          Excess mucus and saliva
          Increase in vaginal discharge
          Mild shortness of breath
          Lightheadedness or dizziness
          Gas and/or constipation
          Skin and hair changes
          Feeling warm or easily overheated

           

          On Your Mind

          You're hitting your stride as the wooziness and uncertainties of the first three months fade away, and the discomforts of late pregnancy still lie relatively far ahead.
           
        • Feeling better and having more energy, you may be ready to conquer the world, or at least the nursery. For many women, the starter's pistol on motherhood goes off right when they feel baby's first pokes and prods. The palpable presence of your child may trigger a series of mothering emotions-protectiveness, nurturing, nesting-and complete and total impatience with anyone who poses a potential threat to the well-being of you and your child.

           

          At the Doctor's or Midwife's Office

          If didn't get to listen to your baby's heartbeat last month, you'll likely get your chance with this visit. Women who have chosen to take an alpha-fetoprotein (AFP) test will have their blood drawn sometime between weeks sixteen and eighteen.

           
           
          Month Five of Your Pregnancy
           
          This month, you're still enjoying the relative comfort level of the second trimester, but your energy and initiative may be slightly dampened by the dwindling quality of your sleep. Sleep deprivation can also contribute to mental fuzziness and emotional edginess. Now's the time to value and prioritize time spent sleeping.
           
          Month Five Checklist
          • Plan a special night out with your partner.
          • Choose a method of childbirth instruction.
          • Tour childbirth centers.
             
            Your Baby This Month
            At ten to twelve inches long and around a pound in weight, your baby is about the size of a football. He is starting to bulk up a bit as he accumulates deposits of brown fat under his skin. This insulation will help regulate his body temperature in the outside world. He's using his bulk to make his presence known; if you weren't feeling him last month you likely are now.
          •  

            Your baby is now covered in a white oily substance known as vernix caseosa, a sort of full-body fetal ChapStick that keeps his fluid-soaked skin from peeling and protects against infection.

            Your Body's Changes
            As your baby grows, your muscles and ligaments stretch to support this new weight. The result may be a new set of aches and pains as your body adjusts to the load.
             
          • The skin of your belly is stretching, tightening, and itching like crazy. A good moisturizing cream can relieve the itching and keep your skin hydrated, although it won't prevent or eliminate striae gravidarum, or stretch marks.
          •  

            The band of ligaments supporting your uterus is carrying an increasingly heavy load. You may start to feel occasional discomfort in your lower abdomen, inner thighs, and hips called round ligament pain. Pelvic tilt exercises are useful for keeping pelvic muscles toned and relieving pain. To perform the pelvic tilt:

            1. Kneel on all fours on the floor.
            2. Keeping your head aligned with your spine, pull in your abdomen, tighten your buttocks, and tilt your pelvis forward. Your back will naturally arch up.
            3. Hold the position for three seconds, then relax. (Remember to keep your back straight in this neutral position.)
            4. Repeat the tilt three to five times, eventually working up to ten repetitions.
            5.  
            The root of all things uncomfortable—pregnancy hormones—are also contributing to lower back pain you may be experiencing. Progesterone and relaxin—the hormone responsible for softening your pelvic ligaments for delivery—are also loosening up your lower back ligaments and disks, and combined with the weight of your growing belly your back is feeling the strain.
          •  

            If your abdominal and/or back pains are severe or accompanied by any of the following, call your healthcare provider immediately:

            • Fever
            • Vomiting
            • Vaginal bleeding
            • Leg numbness
            •  
            Most minor back pain of pregnancy is completely normal, but in severe cases it can be a sign of preterm labor, kidney infection, or other medical problems.
          •  

            To help you ease your aches and pains:

            Stand tall. Try to keep your center of gravity in your spine and pelvis rather than out in your belly, which can give you a swayback.

            Sit up straight. Use good posture when you're sitting as well and choose a chair with good lower back support. You can purchase a special ergonomic support pad for your chair back, but a small pillow may do the trick just as easily.

            Avoid twists and turns. With everything so loose, a sudden move as simple as quickly turning at the waist to get out of bed may strain your back. Use your arms as support for a slow takeoff when rising from a chair.

            Practice your pickups. If you have small children who still need to be lifted occasionally, it's essential to use good form. To avoid injury, bend and use your leg muscles to lift things rather than bending from the waist and lifting with your back.

            Warm up. A warm pad on your back, hips, or other sore spots may help relieve pain.

            Wear sensible shoes. Avoid high heels! They will place further stress on your spine.

            Rest your feet. Use a low stool or step to rest your feet when sitting. If you must stand for long periods, alternate resting each foot on a step.

            Massage. You now have a medical excuse to indulge in a regular back rub from your significant other. A licensed massage therapist who is experienced in prenatal massage may also be helpful.

            Fluff and stuff. Sleep on your side with a pillow placed between your legs. This will align your spine and improve your sleeping posture. A full-sized body pillow or beanbag may help support your back and belly as well.

            Exercise. Stretching and flexibility exercises may help.
          •  

            Symptoms you may start or continue to experience this month include the following. Check off any that you are experiencing so that you may ask your doctor about relief and to track the progress of your pregnancy.

            Hot flashes
            Nausea
            Fatigue
            Frequent urination
            Tender and/or swollen breasts
            Bleeding gums
            Excess mucus and saliva
            Increase in vaginal discharge
            Mild shortness of breath
            Lightheadedness or dizziness
            Headaches
            Gas
            Heartburn
            Constipation
            Skin and hair changes

             

            At the Doctor's or Midwife's Office

            Beyond the usual weigh and measure routine, your doctor or midwife may administer an oral glucose tolerance test (OGTT) at the end of the month, between weeks twenty-four and twenty-eight.  If your doctor or midwife hasn't discussed counting fetal movements before, he or she may mention it now.

             
             
            Month Six of Your Pregnancy
             
            At six months, you may feel as though you'll be pregnant forever, but the final trimester will come and go before you know it. Take some time this month to savor pregnancy and treat yourself to some of the indulgences that only a mother-to-be can pull off.
             
            Month Six Checklist
            • Take a day off and pamper yourself.
            • Start putting together your birth plan.
            • Think about who you want in the delivery room.
            • Begin listing baby names.
               
              Your Baby This Month
              Feeling a rhythmic lurch in your abdomen? Your little girl probably has the hiccups, a common phenomenon thought to be brought on by drinking and/or breathing amniotic fluid. They'll go away on their own, eventually.
            •  
              The once-transparent skin of your baby is starting to thicken, and sweat glands are developing below the skin surface. She's over a foot long now, and by the end of the month she may weigh up to two pounds.
               
              Your Body's Changes
              Your uterus extends well above your navel now. You may actually be seeing fetal movement across your abdomen as your baby gets comfortable in her shrinking living space. You will also notice that your feet have begun to swell. This is a result of the dramatic increase in blood volume you've experienced, which is feeding excess fluids to surrounding tissues, resulting in edema (or water retention). To make matters worse, the weight of your uterus is requiring the veins in your legs to work double time to pump all that extra blood back to your heart. Estrogen also increases the amount of fluid your tissues absorb.
               
            • The result of all this is puffy and sometimes aching feet. Putting your feet up when you can, wearing comfortable low-heeled shoes, and soaking your feet in cool water are all good ways to ease the discomfort. Special compression stockings, available at medical supply stores, may also be helpful.
            •  

              If you experience sudden and severe swelling of the face and hands, call your doctor or midwife immediately. It may be a sign of preeclampsia, also called toxemia, a condition that is potentially hazardous to both you and your baby. Other signs of preeclampsia include:

              • High blood pressure
              • Headaches
              • Visual disturbances
              • Sudden excessive weight gain
              • Protein in the urine
              •  

              Symptoms on the menu yet again this month include the following. Check off any that you are experiencing so that you can ask your doctor or midwife about them and to track the progress of your pregnancy:

              Nausea
              Fatigue
              Frequent urination
              Tender and/or swollen breasts
              Bleeding gums
              Excess mucus and saliva
              Increase in vaginal discharge
              Mild shortness of breath
              Lightheadedness or dizziness
              Headaches
              Forgetfulness
              Gas
              Heartburn
              Constipation
              Skin and hair changes
              Round ligament pain or soreness
              Lower back aches
              Mild swelling of legs, feet, and hands
              Leg cramps

               

              On Your Mind

              As you sidle up to the third trimester starting line, try to take advantage of these final days of relative comfort and sit back and savor your pregnancy. Try each of these ways to pamper yourself:
              • Splurge for a day spa treatment.
              • Spend a lazy afternoon curled up with a good book.
              • Cool off with a dish of your favorite Ben & Jerry's flavor.
              • Enjoy a nice, relaxing soak in the tub.
              • Take a scenic weekend drive with no deadlines or particular destination.
              • Use the valet service to park instead of hiking from the lot.
              • Order healthy carry-out fare from your favorite restaurant.

                 

                At the Doctor's or Midwife's Office
                There will be more of the same this month as your provider checks your weight and fundal height, listens to your baby's heartbeat, and finds out about any new pregnancy symptoms you may be experiencing. Your doctor or midwife will also require the usual urine sample and blood pressure check.
              •  

                If you weren't given an oral glucose tolerance test to screen for gestational diabetes last month, it will probably be administered now.

                 
                 
                Month Seven of Your Pregnancy
                 
                You're likely feeling perpetually stuffed and slightly out of breath as your uterus relocates all your internal organs. The relief and energy felt in the second trimester may start to fade now. Just remember, you're almost there.
                 
                Month Seven Checklist
                • Make a date with yourself to relax, read, or just catch up on sleep.
                  • Interview pediatricians.
                  • Sign up for childbirth classes.
                  • Contemplate the breast versus bottle decision.
                  • Set up an appointment to discuss your birth plan with your provider.
                  •  

                  Weighing in at four pounds and about sixteen inches long, your baby is growing amazingly fast now. His red, wrinkled skin is losing its fine lanugo covering as more insulating fat accumulates. And his eyelids, closed for so long, can now open and afford him a dim view of the place he will call home for just a few more months.

                  Dramatic developments in the brain and central nervous system are also occurring. Your baby feels pain, can cry, and responds to stimulation from light or sound outside the womb. Periodically, tiny elbows and feet will turn your belly into an interactive relief map.
                •  
                  Your Body's Changes
                  The top of the fundus is halfway between your belly button and your breastbone, displacing your stomach, intestines, and diaphragm. Your breasts are heavier and more glandular and are getting ready to feed your baby. In this last trimester, your nipples may begin to leak colostrum, which is the yellowish, nutrient-rich fluid that precedes real breast milk. To reduce backaches and breast tenderness, make sure you wear a well-fitting bra, even to bed if it helps. If you are planning on breastfeeding, you may want to start buying the following few things now that can take you through the rest of pregnancy and right into the postpartum period in preparation for nursing:
                  • Nursing bra: Try out the clasps for easy nursing access. Try to unfasten and slip the nursing flaps down with one hand.
                  • Sports bra: Instead of a nursing bra, you may opt for the comfort of a sports bra that slides up easily.
                  • Easy-access shirts: Button-up blouses, shirts with zippers, and other easy-access clothing will make nursing easier on a day-to-day basis.
                  • Nursing pads: These pads, which catch leaks before they soak through your shirt, come in several different materials and configurations, including cloth, plastic, and disposable.

                  If you will not be breastfeeding but using formula or bottlefeeding breast milk instead, look for a bottle with these characteristics:

                  • Low air flow: Designs that minimize air or can be de-aired prior to feeding may reduce your baby's gas.
                  • Convenience: If saving time is a priority, features like presterilized disposable bag bottles are a big plus.
                  • Easy to clean: Pick something with minimal parts that looks relatively easy to clean and sterilize.
                  • Built for baby: Make sure your baby gets a newborn-style nipple with a smaller opening to start so he doesn't face a formula tidal wave. If his sucking reflex is weak, however, you may have to upgrade to a larger opening.
                   
                • Your body is warming up for labor, and you may start to experience Braxton Hicks contractions. These painless and irregular contractions feel as if your uterus is making a fist and then gradually relaxing it. If your little one is fairly active, you may think that he is stretching himself sideways at first. A quick check of your belly may reveal a visible tightening.
                •  

                  Braxton Hicks can begin as early as week twenty and continue right up until your due date, although they're more commonly felt in the final month of pregnancy.

                  The list is growing. Other symptoms that may continue this month include:

                  Fatigue
                  Frequent urination
                  Tender and/or swollen breasts
                  Bleeding gums
                  Excess mucus and saliva
                  Increase in vaginal discharge
                  Mild shortness of breath
                  Lightheadedness or dizziness
                  Headaches
                  Forgetfulness
                  Gas
                  Heartburn
                  Constipation
                  Skin and hair changes
                  Round ligament pain or soreness
                  Lower back aches
                  Mild swelling of legs, feet, and hands
                  Leg cramps

                   

                  On Your Mind

                  As labor looms closer your thoughts turn to the task at hand. Going into labor and delivery with as much knowledge of the process as possible can make the difference between a positive childbirth experience and a long and arduous one. You may now be wondering whether you are up to the task of labor and whether you will be up to the task of motherhood.
                   
                • Remember that women have been doing this since the beginning of time, and under much more difficult circumstances. In most cases labor will be hard work, but if you prepare yourself by learning what to expect, you will be ready to face whatever comes your way.
                •  

                  Also keep in mind that great moms are made, not born. While some parts of mothering will seem to come to you instinctively, practice and trial and error will make up the better part of your parenting education. Use the tools around you-your pediatrician, other mothers, and research and reading-to build and sharpen your skills, but listen to your inner voice in the final analysis and application of what you learn.

                  At the Doctor's or Midwife's Office

                  Starting with this initial third-trimester visit, your visits to the doctor may start to step up to twice monthly. Women who are Rh negative will need treatment with Rh immune globulin (RhoGAM) this month. An injection is typically given at about twenty-eight weeks to protect the fetus from developing hemolytic disease—a condition in which the mother's antibodies attack the fetal red blood cells.
                   
                   
                  Month Eight of Your Pregnancy
                   
                  You are a pregnancy pro now, deftly handling all the aches and pains that come with the territory. You've learned to adjust to the fashion hardships, the lifestyle changes, and the logistical challenges that your baby and belly have brought to the forefront. It's not much longer now.
                   
                  Month Eight Checklist
                  • Take five and de-stress; it's good for you and baby.
                  • Lay out your baby's essentials.
                  • Compare and decide on cloth versus disposal diapers.
                  • Discuss circumcision with your pediatrician and your partner.
                  • Start wrapping up projects at work.
                  • Finalize your child care plans for after maternity leave.
                  • Preregister at your hospital or birthing center.
                     
                    Your Baby This Month
                    Gradually shifting to the same position in which 95 percent of all babies are born, your baby starts to move into a head down pose, known as the vertex position.
                     
                  • Your little one is now up to eighteen inches long and as heavy as a five-pound sack of flour. The rest of her body is finally catching up to the size of her head. Although it may feel like your baby is constantly up and about, she's actually sleeping 90 to 95 percent of the day, a figure that will drop only slightly when she is born.
                  •  

                    If your child were born today, she'd have an excellent chance of surviving and eventually thriving outside the womb. However, she'd still be considered preterm or premature, just as any birth before thirty-seven weeks of gestation.

                    Your Body's Changes
                    Weight gain should start to slow down this month. If it doesn't, however, don't cut your calorie intake below 2,600 to try and stop it. You need the extra energy for both of you.
                     
                  • As your baby settles firmly on your bladder, bathroom stops step up once again. You may even experience some stress incontinence, which is minor dribbling or leakage of urine when you sneeze, cough, laugh, or make other sudden movements. This should clear up postpartum.
                     
                  • Other symptoms that may begin or continue this month include:
                    Fatigue
                    Frequent urination
                    Tender and/or swollen breasts
                    Colostrum discharge from nipples
                    Bleeding gums
                    Excess mucus and saliva
                    Increase in vaginal discharge
                    Mild shortness of breath
                    Lightheadedness or dizziness
                    Headaches
                    Forgetfulness
                    Gas
                    Heartburn
                    Constipation
                    Skin and hair changes
                    Round ligament pain or soreness
                    Lower back aches
                    Mild swelling of legs, feet, and hands
                    Leg cramps
                    Painless, irregular Braxton Hicks contractions
                    Minor vision changes (fluid retention can slightly change the shape of your eyes and estrogen can cause your eyes to be drier than normal

                     

                    On Your Mind

                    As labor looms closer, your thoughts turn to the task at hand. Going into labor and delivery with as much knowledge of the process as possible can make the difference between a positive childbirth experience and a long and arduous one, so continue to read and ask questions.

                     

                    At the Doctor's or Midwife's Office
                    You'll see your provider twice this month as you continue your every-other-week routine. He or she will check the position of your baby to determine if she has turned head down in preparation for birth.
                     
                     
                    Month Nine of Your Pregnancy
                     
                    The grand finale is approaching. You may feel like you've been waiting forever. But even if you had the time of conception pinpointed, your baby may decide he needs a little more, or a little less, time preparing. Never fear; he will arrive sooner or later.
                     
                    Month Nine Checklist
                    • Make sure that your other children's teachers and care providers are aware of your impending hospital stay.
                    • Pack your bag and compile a call list for your partner.
                    • Line up postpartum assistance.
                    • Stock up the freezer with heat-and-eat meals or recruit postpartum kitchen help.
                    • Make a plan, and a back-up plan, for getting to the hospital.
                    • Put your feet up, relax, and take a deep breath. The rest is up to your baby.
                       
                      Your Baby This Month

                      Your child is packing on about a half-pound per week as he prepares to make his big exit. He's fully formed and just waiting for the right time now. His lungs, the last organ system to fully mature, now have an adequate level of surfactant in them to allow for breathing outside of the womb.

                      Your Body's Changes

                      Whilte your baby is still growing, your weight gain tapers off, and you may even lose a pound or so due to a drop in amniotic fluid production. Many more things are happening this month. Check off those you experience, note when they occur, and call your doctor or midwife with any questions.

                      Groin soreness
                      Backache
                      As your cervix thins and dilates (opens), the soft mucous plug keeping it sealed tight may be dislodged
                      Increased need to urinate
                      Feel shockwaves through your pelvis as your baby settles further down onto the pelvic floor
                    •  

                      Braxton Hicks contractions may be more frequent this month as you draw nearer to delivery. You're close enough to be on the lookout for the real thing, however. You know you are experiencing real contractions when they:

                      • Are felt in the back and possibly radiate around to the abdomen.
                      • Do not subside when you move around or change positions.
                      • Increase in intensity with activity like walking.
                      • Increase in intensity as time passes.
                      • Come at roughly regular intervals (early on this may be from twenty to forty-five minutes apart).
                       
                    • Other signs that labor is on its way include amniotic fluid leaks in either a gush or a trickle (your water breaking), sudden diarrhea, and the appearance of the mucous plug. For many women, the bag of waters does not break until active labor sets in.
                       
                      On Your Mind

                      You're likely tired but happy as you pack and prepare for the big day. Just remember the "estimated" in estimated delivery date to avoid a big letdown if baby is tardy.

                      As sleep gets more and more elusive and your discomfort increases, you may find yourself easily provoked. To keep your cool and limit anxiety:

                      • Stay clear of encounters with people you know will irritate you.
                      • Ask your significant other to be the point person on all "anything yet?" questions.
                      • Take a deep breath and go over what you learned in childbirth class.
                      • Talk with your partner or labor coach about ways to relax.
                      •  
                      • Ask your provider any questions that may still be on your mind about labor and delivery.

                         

                        At the Doctor's or Midwife's Office

                        You'llsee your doctor or midwife on a weekly basis now until you deliver. You should expect that your provider will:

                        • Perform an internal exam with each visit to check your cervix for changes that indicate approaching labor.
                        • Administer a group B strep (GBS) test one month prior to your estimated delivery date.
                        • Take note of any descent or dropping of the baby toward the pelvis. This descent is called the pelvic station.