Month 9

Month 9
External Features: Toenails grow up to the tip of the toes and fingernails grow beyond the fingertips. The skin is fully covered in vernix caseosa (which serves to protect the epidermis) and most of the lanugo hairs are shed. By this time, the placenta weighs about 500grams and the umbilical cord becomes central in the abdomen. Organ Systems: Internally, the fetus secretes large amounts of pulmonary surfactant (a mixture of phospholipids and protein; it will eventually line the aveoli and lower the surface tension in mature lungs at birth). The tip of the spinal cord grows to the level of L3 and myelination of the brain begins. Although in female fetuses the ovaries are still above the brim of the pelvis, the testes in males have fully descended into the scrotum.

 Finally, after 40 (on average) weeks of gestation, the fetus is fully developed and ready for birth.

Month 8

Month 8
External Features: By the eighth month, the skin is pink and smooth, the eyes are capable of reacting to light and the fingernails have grown long enough to reach the tip of the fingers.
Organ Systems: Internally, at the eighth month, the hyaloid vessels nourishing the eye lens, regresses and the testes begin entering the scrotum.

Month 7

Within the three months of the third trimester, a fetus goes from incomplete development to complete, fetal maturity.

Month 7
External Features: At seven months, the fetus continues the development of hair and the scalp hairs grow beyond the length of the thin lanugo hairs that developed during the second trimester. Eyelashes are well developed and eyelids begin to open.
Organ Systems: Internally, the fetus' brain continues to develop and throughout the body subcutaneous fat storage begins. In male fetuses the testes continue descending into the scrotum.

The Second Trimester

 

 

 

 

 

 

 

 

 

 

 

 

Prenatal visits during the second trimester:

During the second and third trimester prenatal visits, your physician may check the following, depending on your current medical condition and the health of the fetus:

·                                 any current symptoms or discomforts

·                                 mother's weight

·                                 mother's blood pressure

·                                 urine test - to detect albumin (a protein) which may indicate preeclampsia or toxemia, and sugar (which may indicate hyperglycemia)

·                                 growth, size, and development of the fetus

·                                 size of the uterus - after approximately 12 weeks of gestation, the uterus can be felt through the abdominal wall

·                                 height of the fundus (top of the uterus)

·                                 fetal heartbeat

What to expect during the second trimester:

The second trimester marks a turning point for mother and fetus. The mother usually begins to feel better and will start showing the pregnancy more. The fetus has now developed all its organs and systems and will now focus on growing in size and weight.

During the second trimester, the umbilical cord continues to thicken as it carries nourishment to the fetus. However, harmful substances also pass through the umbilical cord to the fetus, so care should be taken to avoid alcohol, tobacco, and other known hazards.

During the second trimester, both the mother's body and the fetus continue to grow.

Fetal development during the second trimester:

Now that all the major organs and systems have formed in the fetus, the following six months will be spent growing. The weight of the fetus will multiply more than seven times over the next few months, as the fetus becomes a baby that can survive outside of the uterus.

By the end of the second trimester, the fetus will be about 13 to 16 inches long and weighs about 2 to 3 pounds. Fetal development during the second trimester includes the following:

·                                 The fetus kicks, moves, and can turn from side to side.

·                                 The eyes have been gradually moving to the front of the face and the ears have moved from the neck to the sides of the head. The fetus can hear the mother's voice.

·                                 A creamy white substance (called vernix caseosa, or simply vernix) begins to appear on the fetus and helps to protect the thin fetal skin. Vernix is gradually absorbed by the skin, but some may be seen on babies even after birth.

·                                 The fetus is developing reflexes such as swallowing and sucking.

·                                 The fetus can respond to certain stimuli.

·                                 The placenta is fully developed.

·                                 The brain will undergo its most important period of growth from the 5th month on.

·                                 Fingernails have grown on the tips of the fingers and toes, and the fingers and toes are fully separated.

·                                 The fetus goes through cycles of sleep and wakefulness.

·                                 Skin is wrinkly and red, covered with soft, downy hair (called lanugo).

·                                 Hair is growing on the head of the fetus.

·                                 Fat begins to form on the fetus.

·                                 Eyelids are beginning to open and the eyebrows and eyelashes are visible.

·                                 Fingerprints and toeprints have formed.

·                                 Rapid growth is continuing in fetal size and weight.

·                                 The 20th week marks the halfway point of the pregnancy.

A fetus born at the end of 24 weeks may survive in a neonatal intensive care unit.

Changes in the mother's body:

The second trimester is the most physically enjoyable for most women. Morning sickness usually abates by this time and the extreme fatigue and breast tenderness usually subsides. These changes can be attributed to a decrease in levels of human chorionic gonadotropin (hCG) hormone and an adjustment to the levels of estrogen and progesterone hormones.

The following is a list of changes and symptoms that may occur during the second trimester:

·                                 Appetite may increase.

·                                 The mother may be able to feel the movement of the fetus for the first time - a phenomenon called quickening - by 20 weeks.

·                                 The uterus has grown to the height of the belly button, making the pregnancy visible.

·                                 The skin on the belly may itch as it grows and there may be pain down the sides of the body as the uterus stretches. The lower abdomen may ache as ligaments stretch to support the uterus.

·                                 The need to frequently urinate may decrease as the uterus grows out of the pelvic cavity, relieving pressure on the bladder.

·                                 A mother's nose may become congested and she may experience nosebleeds. This is due to the increase in hormones (estrogen and progesterone) that affect the mucous membranes in the nose.

·                                 A woman's gums become more spongy and may bleed easily. This is due to the increase in hormones (estrogen and progesterone) that affect the mucous membranes in the mouth.

·                                 Varicose veins and hemorrhoids may appear.

·                                 A woman may have a white-colored vaginal discharge called leukorrhea. (A colored or bloody discharge may signal possible complications and should be examined immediately.)

·                                 The increasing weight gain may cause backaches.

·                                 Skin pigmentation may change on the face or abdomen due to the pregnancy hormones.

·                                 Heart burn, indigestion, and constipation may continue.

The First Trimester

The first prenatal visit:

The first prenatal visit is the most thorough. A complete medical history is taken, a physical examination is conducted, as well as certain tests and procedures are performed to assess the initial health of the mother and her unborn baby. The first prenatal visit may include the following:

·                                 personal medical history - this may include previous and current medical conditions, such as diabetes, high blood pressure (hypertension), anemia, and/or allergies; current medications, such as prescription and over-the-counter; or previous surgeries

·                                 maternal and paternal family medical history - including illnesses such as diabetes or mental retardation, and genetic disorders such as sickle cell disease or Tay-Sachs disease

·                                 personal gynecological and obstetrical history - including past pregnancies - stillbirths, miscarriage, deliveries, terminations - and menstrual history (i.e., length and duration of menstrual periods)

·                                 education - including a discussion regarding the importance of proper nutrition, regular exercise, the avoidance of alcohol, drugs, and tobacco during pregnancy, and a discussion of any concerns about domestic violence

·                                 pelvic examination - this type of examination may be performed for reasons includingto note the size and position of the uterus; to determine the age of the fetus; to check the pelvic bone size and structure; or to perform a Pap test (also called Pap smear) to detect the presence of abnormal cells.

·                                 laboratory tests - this includes urine tests (to screen for bacteria, sugar, and protein) and blood tests (to determine blood type)

All pregnant women are tested for the Rh factor during the early weeks of pregnancy. A mother and fetus may have incompatible blood types, the most common is Rh incompatibility. Rh incompatibility occurs when the mother's blood is Rh-negative and the father's blood is Rh-positive and the fetus' blood is Rh-positive. The mother may produce antibodies against the Rh-positive fetus which may lead to anemia in the fetus. Incompatibility problems are monitored and appropriate medical treatment is available to prevent the formation of Rh antibodies during pregnancy.

·                                 blood screening tests - to detect diseases (i.e., rubella, also called German measles)

·                                 genetic tests - to detect inherited diseases (i.e., sickle-cell anemia, Tay-Sachs disease)

·                                 screening tests - to detect infectious diseases (i.e., sexually transmitted diseases)

The first prenatal visit is also an opportunity to ask any questions or discuss any concerns that you may have about your pregnancy.

What to expect during the first trimester:

A healthy first trimester is crucial to the normal development of the fetus. The mother-to-be may not be showing much on the outside, but inside her body all the major body organs and systems of the fetus are forming.

As the embryo implants itself into the uterine wall, several developments take place, including:

·                                 amniotic sac

A sac filled with amniotic fuid, called the amniotic sac, surrounds the fetus throughout the pregnancy. The amniotic fluid is liquid made by the fetus and the amnion (the membrane that covers the fetal side of the placenta) that protects the fetus from injury and helps regulate the temperature of the fetus.

·                                 placenta
The placenta is an organ shaped like a flat cake that only grows during pregnancy. It attaches to the uterine wall with tiny projections called villi. Fetal blood vessels grow from the umbilical cord into these villi, exchanging nourishment and waste products with the mother's blood. The fetal blood vessels are separated from the mother's blood supply by a thin membrane.

·                                 umbilical cord
The umbilical cord is a rope-like cord connecting the fetus to the placenta. The umbilical cord contains two arteries and a vein, which carry oxygen and nutrients to the fetus and waste products away from the fetus.

It is during this first trimester that the fetus is most susceptible to damage from substances such as alcohol, drugs, certain medications, and illnesses such as rubella (German measles).

During the first trimester, both the mother's body and the fetus are changing rapidly.

Fetal development during the first trimester:

The most dramatic changes and development occur during the first trimester. During the first eight weeks, a fetus is called an embryo. The embryo develops rapidly and by the end of the first trimester it becomes a fetus that is fully formed, weighing approximately 1/2 to one ounce and measuring, on average, three to four inches in length.

First trimester growth and development benchmarks:

Just as each child grows and matures at different rates and at different times, so does that same child as it begins its life in the womb. The chart provided below provides benchmarks for most normal pregnancies. However, each fetus develops differently.

By the end of 4 weeks	·                                 all major systems and organs begin to form ·                                 the embryo looks like a tadpole ·                                 the neural tube (which becomes the brain and spinal cord), the digestive system, and the heart and circulatory system begin to form ·                                 the beginnings of the eyes and ears are developing ·                                 tiny limb buds appear (which will develop into arms and legs) the heart is beating
By the end of 8 weeks	·                                 all major body systems continue to develop and function, including the circulatory, nervous, digestive, and urinary systems ·                                 the embryo is taking on a human shape, although the head is larger in proportion to the rest of the body ·                                 the mouth is developing tooth buds (which will become baby teeth) ·                                 the eyes, nose, mouth, and ears are becoming more distinct ·                                 the arms and legs are clearly visible ·                                 the fingers and toes are still webbed but can be clearly distinguished ·                                 the main organs continue to develop and you can hear the baby's heartbeat using an instrument called a Doppler ·                                 the bones begin to develop and the nose and jaws are rapidly developing the embryo is in constant motion but cannot be felt by the mother
From embryo to fetus	After 8 weeks, the embryo is now referred to as a fetus (which means offspring). Although the fetus is only 1 to 1 1/2 inches long at this point, all major organs and systems have been formed.
During weeks 9-12	·                                 the external genital organs are developed ·                                 fingernails and toenails appear ·                                 eyelids are formed ·                                 fetal movement increases ·                                 the arms and legs are fully formed ·                                 the voice box (larynx) begins to form in the trachea The fetus is most vulnerable during the first 12 weeks. During this period of time, all of the major organs and body systems are forming and can be damaged if the fetus is exposed to drugs, German measles, radiation, tobacco, and chemical and toxic substances. Even though the organs and body systems are fully formed by the end of 12 weeks, the fetus cannot survive independently.

Changes in the mother's body:

During pregnancy, many changes are also occurring in the mother-to-be's body. Women experience these changes differently. Some symptoms of pregnancy continue for several weeks or months, while others are only experienced for a short period of time. Some women experience many symptoms, while other women experience only a few or none at all. The following is a list of changes and symptoms that may occur during the first trimester:

·                                 The mammary glands enlarge causing the breasts to swell and become tender in preparation for breastfeeding. This is due to an increased amount of the hormones estrogen and progesterone. A supportive bra should be worn.

·                                 A woman's areolas (the pigmented areas around each breast's nipple) will enlarge, darken, and may become covered with small, white bumps called Montgomery's tubercles (enlarged sweat glands).

·                                 Veins become more prominent on the surface of the breasts.

·                                 The uterus is growing and begins to press on the woman's bladder, causing the need for her to urinate more frequently.

·                                 Partly due to surges in hormones, a pregnant woman may experience mood swings similar to premenstrual syndrome (a condition experienced by some women that is characterized by mood swings, irritability, and other physical symptoms that occur shortly before each menstrual period).

·                                 Increased levels of hormones to sustain the pregnancy may cause "morning sickness," which is feelings of nausea and sometimes vomiting. However, morning sickness does not necessarily occur just in the morning and rarely interferes with proper maternal and fetal nutrition.

·                                 Constipation may occur as the growing uterus presses on the rectum and intestines.

·                                 The muscular contractions in the intestines, which help to move food through the digestive tract, are slowed due to high levels of progesterone. This may, in turn, cause heartburn, indigestion, constipation, and gas.

·                                 Clothes may feel tighter around the breasts and waist, as the size of the abdomen begins to increase to accommodate the growing fetus.

·                                 A woman may experience fatigue due to the physical and emotional demands of pregnancy.

·                                 Cardiac volume increases by approximately 40 to 50 percent from the beginning to the end of the pregnancy, causing an increased cardiac output. An increased cardiac output may cause an increased pulse rate during pregnancy. The increase in blood volume is needed for extra blood flow to the uterus.

Dancing or playing or something

It feels wonderful all the time.
The movement of my little one inside me.
Truly amazing.
I do not want to give this up.
It makes me giggle and feel so happy.

Easing Labor Pain

Exercise! -- By Sara Hambidge, Physical Therapist

Why is it that some women experience a labor that lasts two hours when others are in labor for 14 hours? How do some women go natural despite the potential intense pain involved? Why do some women tear when others do not?

Is there a way to ease the delivery process? Research says YES - through exercise, especially routines involving the pelvic floor.

In a recent study cited in the British Medical Journal, researchers noted that of the 300 women studied, those who did intensive pelvic floor/kegel exercises in the last few months of pregnancy had an easier time giving birth. Most affected was the second stage of labor-- the pushing stage-- where the study found that women who had done the exercises were less likely to spend prolonged time. Having a shorter pushing stage is extremely beneficial, since a longer pushing phase can lead to a tear or episiotomy, as well as increased chances for bleeding or requiring Cesarean delivery.
Kegel ExercisesIt’s been known for a long time that kegel exercises also decrease urinary incontinence, a problem in late pregnancy and postpartum.

And there is no excuse to not do them, since they can be done anywhere without anyone knowing you are doing them! You can do kegel exercises in all positions: sitting standing, lying down. Just tighten the muscles of the pelvic floor (the ones that start and stop the urine flow). Do sets of ten, holding for 5 seconds, 10 times per day.

 

Other ExercisesExercise in general is a good way to prepare for labor, since it will strengthen the body, increase circulation and flexibility, and improve endurance – all needed during labor. A few other exercises that can assist in the labor process:

• Squats help strengthen the legs and pelvic floor, opening up the pelvis. Many natural birth advocates believe this is the optimal position for giving birth, since it opens the birth canal and allows gravity to assist with delivery.
• Tailor sitting and stretching involves sitting on the floor like the stereotypical tailor, with legs crossed. It is one of the most beneficial positions to sit in during pregnancy for many reasons: circulation to the pelvic muscles is increased, and the weight of the baby is supported on the pelvic bones, relieving the pelvic muscles of strain. Stretches the groin and hips, which helps in the second stage of labor (the pushing stage), and alleviates backaches, especially when done with your back against a wall.
• Sit and stretch with legs outstretched until you feel a stretch in the groin and hamstrings, then hold for a minute. With each breath, relax and release further into the stretch.
• Pelvic tilts will assist in strengthening the abdominals and stretching the area of the back that’s usually sore in later pregnancy. The “all fours” position is also a good position during the first stage of labor to ease pain.

No one can predict what your labor will be like, but if your body is physically prepared for it, the anxiety of a long and painful labor can be lessened. Keep the exercises above in mind and hopefully you’ll have an easier labor—one that will allow you to enjoy the ride!