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!

new OB/GYN

So I met with my new doctor and he is wonderful. I wish I would have went to him from the first day I knew I was pregnant. I am looking forward to all his advice and support.
The 2nd ultrasound was great. My husband was fascinated. We went to a specialist because of my age group and after the viewing he said we had very little to worry about and that the results looked like I was in my 20's rather than my 30's. Great news. So we waived the emi test.
I have my glucose test scheduled for Nov 29 along with my first flu shot ever.
I was extremely sick last Sunday and so I was thinking it would be best to get the shot since the doctor recommends it.

Energy Boosts at Work

Stay Alert All Day, Every Day -- By Mike Kramer and Liz Noelcke, Staff Writers

You see the computer screen, but you really don’t. It’s more like a two-foot blur. Your eyes are between open and closed, although you’re not sure where. At the moment, you have no idea what you’re working on. And it’s only 3 p.m. Sound familiar? Is this a typical afternoon or morning? Are you looking for an energy boost at your desk? Office life can suck the energy right out of you, if you let it. But, there are numerous ways to take advantage of your workspace and stay energetic all day.

Did you realize bad posture alone can give your brain up to 30% less blood and oxygen? Along with good posture, the most effective way to fight energy lulls is with heavy doses of good stretching and good breathing. Shoot for five minutes of mental or physical activity per hour, every hour at the computer.

Here are more, different ideas for rejuvenating your mind and body. Each will only take a few minutes.

·                                 Find a few sturdy, thick phonebooks and do some step aerobics.

·                                 Massage your head and shoulders. Find trigger points of tension in the shoulders and base of the skull. Hold pressure for 6-10 seconds. Don’t forget your face and jaw.

·                                 Take two steps back from your desk and lean forward until you’re at an angled push-up position against the edge of your desk. Do a couple quick sets.

·                                 Lift 1-3 packs of printer paper in each hand. Curl them like weights or lift them over your head.

·                                 Close your door and shadow box. Imagining a stressor while you’re punching will increase your energy, guaranteed.

·                                 Jumping jacks. Simple, quick and pumps you up.

·                                 Squeeze a stress ball. Relieves stress while strengthening forearms and wrists for typing.

·                                 Try word puzzles. Keep a jigsaw puzzle in your office.

·                                 Switch hands with whatever you’re doing.

·                                 Stand perfectly still for two minutes. Regroup.

·                                 When you first arrive at work, take as long as possible before sitting down.

·                                 Forget the boardroom. Hold walking meetings.

·                                 Hand-deliver mail, memos and faxes.

·                                 Chat face-to-face instead of by e-mail or phone.

·                                 Use a bathroom on the other side of the building or another floor.

·                                 Have a lot of phone time? Buy a cordless and move around while talking.

Another approach, one that adults rarely consider but could greatly benefit from, is a nap.

A 2001 survey by the National Sleep Foundation found that 63% of Americans don’t get enough sleep. Naps will combat this. They cannot replace a good night’s sleep, but they can help you perform at your peek throughout the day. Plus you can save that daily $4 on Starbucks, because the energy you gain from a nap is better and longer lasting than caffeine. The ideal nap length is 20 minutes, easily squeezable into the workday.

No matter the method, try to find tricks that work for you. Remember, if you don’t want to feel drained at the end of the work day, you don’t have to.

taken from BabyFit.com

Breathing during labour

Breathing often relects our state of relaxation or excitation. When at rest, breathing is usually slow and rhythmic. When tense, breathing may be erratic or we may hold our breath. Controlling brething may help you become aware of your state so you can stay relaxed. Breaqthing techniquest are helpful to many women in labor.
Allow your body to relax as completely as possible and work with the contractions while using the breathing and relaxation techniques. There is no right or wrong way to breathe. The techniques are only guidelines and should be adapted to your individual preference and comfort.
Begin focusing on your breathing when you feel you need help relaxing or can no longer walk or talk through a contraction. For many women, this may be hours into labor. Your breathing should be at a comfortable rate and not cause you to feel short of breath or light-headed.

Your breathing style should be your own. The breath may be taken in and out of your nose or mouth, or in your nose and out your mouth. The key is to have the breathing feel natural, relaxed and even.

Each of the breathing techniques has two common features: a cleansing breath and a focal point.

Cleansing Breath
The use of a cleansing breath before and after every contraction is important. It is an exaggerated, deep breath, usually done by breathing in through the nose and out through the mouth. The purposes of this breath are to:

       Allow for increased oxygen to the baby

       Internally signal you that a contraction is beginning and to remind you to begin concentrating on breathing, focusing, and relaxing.

       Externally signal your partner and anyone else assisting with the labor that a contraction is beginning. They can then offer assistance, such as a back massage or verbal encouragement.

       Allow for blowing off residual tension after a contraction is over.

       Give your baby a boost of oxygen at the end of the contraction.

Focal Point
The use of a focal point will help enhance your relaxation and increase your concentration during a contraction. An internal focal point, such as a peaceful scene or serene setting may work well for some; others may find that they need to concentrate on an object in the room or the partner's eyes. This focus may change during labor, as contractions gain strength. Practice using different focal points that enhance your contraction and help eliminate distractions. (Note: a clock is not used as a focal point.

       Allow the breathing to continue on its own quietly, easily, and evenly. Concentrate on letting yourself completely relax and let your body go limp with each exhale. Picture a rag doll.

       Your body may begin to feel warm and heavy.

       When ready to rouse yourself, breathe in deeply, stretching arms and legs, as you exhale.

Slow Paced Breathing

       Take a "cleansing" breath at the beginning of a contraction

       Continue to breathe evenly in and out with slow,easy abdominal breathing.

       Pace is approximately half your normal respiratory rate.

       You may use Attention Focusing strategies such as:

       Inhalation/exhalation through nose

       Inhalation/exhalation through mouth

       Counting rhythms, imagery, affirming phrases, etc.</LI.

       Movement, stroking, massage, tapping, etc.

       A visual focal point

       As contraction ends, take a "cleansing" breath, breathing out slowly, and relaxing completely.

Modified Paced Breathing

       Easy, rhythmical breathing with a frequency of approximately twice your normal respiratory rate.

       Relaxed movement in chest and abdomen with more use of intercostal (chest) muscle.

       Use as needed for more challenging contractions

       Use same steady rate throughout contraction or use attention focusing strategies as needed.

Patterned Paced Breathing

       Even, rhymthmical breathing approximately twice your normal respiratory rate.

       Breathing pattern does not change rate or volume of air exchange.

       Pattern 3 breath/1 "blow"

       Use Attention Focusing strategies as needed.

Variations of Patterned Paced Breathing

       Pattern can be from 1 breath/1 blow to 6 breaths/1 blow.

       Can use Patterned Paced breathing in 1 breath/1 blow (He/Who)

       Try pattern of 5/1, 4/1, 3/1, 2/1, 1/1, 2/1, 3/1, 4/1, 5/1

       Combine paced breathing techniques in one contraction.

       Use attention focusing strategies as needed.

taken from Lamaze.com