Your Pregnancy

Your pregnancy: 10 weeks
See the big picture
How your baby's growing:

Though he's barely the size of a kumquat — a little over an inch or so long, crown to bottom — and
weighs less than a quarter of an ounce, your baby has now completed the most critical portion of his
development. This is the beginning of the so-called fetal period, a time when the tissues and organs in
his body rapidly grow and mature.
He's swallowing fluid and kicking up a storm. Vital organs — including his kidneys, intestines, brain, and
liver (now making red blood cells in place of the disappearing yolk sac) — are in place and starting to
function, though they'll continue to develop throughout your pregnancy.
If you could take a peek inside your womb, you'd spot minute details, like tiny nails forming on fingers
and toes (no more webbing) and peach-fuzz hair beginning to grow on tender skin.
In other developments: Your baby's limbs can bend now. His hands are flexed at the wrist and meet over
his heart, and his feet may be long enough to meet in front of his body. The outline of his spine is clearly
visible through translucent skin, and spinal nerves are beginning to stretch out from his spinal cord. Your
baby's forehead temporarily bulges with his developing brain and sits very high on his head, which
measures half the length of his body. From crown to rump, he's about 1 1/4 inches long. In the coming
weeks, your baby will again double in size — to nearly 3 inches.
See what your baby looks like this week.
Note: Every baby develops a little differently — even in the womb. Our information is designed to give
you a general idea of your baby's development.
How your life's changing:

At your next prenatal visit, you may be able to hear your baby's rapid heartbeat with the help of a
Doppler stethoscope, a handheld ultrasound device that your practitioner places on your belly. Many
women say that the beating of their baby's tiny heart sounded like the thunder of galloping horses and
hearing it for the first time was very moving.
Before you got pregnant, your uterus was the size of a small pear. By this week, it's as big as a
grapefruit. You may or may not be ready for maternity wear now. Even if you're not there yet, your
regular clothes are probably feeling uncomfortably tight and your blossoming breasts are straining the
seams of your bra. The thickening in your midsection is most likely due to slight weight gain and
bloating. If you're between regular and maternity clothes, pants and skirts with forgiving elastic
waistbands (or low-rise waistlines that sit below your belly) will provide some much-needed comfort.
Depending on your level of fitness, you can most likely participate in a wide range of activities during
pregnancy. Swimming and walking are excellent choices for the whole nine months. Exercise promotes
muscle tone, strength, and endurance — three qualities that can help you carry the weight you gain
during pregnancy, prepare you for the physical stress of labor, and make it easier to get back into shape
after your baby is born. (Unfortunately, there's no evidence that regular exercise shortens labor.)
Dealing with evening sickness "My version of morning sickness developed every evening around dinnertime. I
couldn't eat anything, but I was starving (and cranky) nonetheless. Things improved after I adjusted my schedule,
eating my big meal in the morning and something light — usually crackers and cheese or cereal — for dinner." —
Susan
3 Questions About Infections during pregnancy

Q1. What do I need to know about urinary tract infections during pregnancy?
Urinary tract infections (UTIs) are the most common bacterial infection during pregnancy. Higher levels
of progesterone are partly to blame. The hormone relaxes your urinary tract, which may slow the flow of
urine, giving bacteria more time to grow. Later in pregnancy, other factors come into play as well.
An infection occurs when intestinal bacteria travel from your rectum to your urethra and make their way
up your urinary tract, where they continue to multiply. Sometimes they cause a bladder infection called
cystitis. Symptoms of cystitis include pain, discomfort, or burning when urinating, a more frequent urge
to pee, and pelvic discomfort or lower abdominal pain. Your urine might look cloudy and have a foul
smell.
It's important to see your caregiver if you think you have a bladder infection. Untreated cystitis can lead
to a kidney infection that can make you seriously ill and increase your risk for preterm labor. If you do
have cystitis, your practitioner will prescribe antibiotics that are safe during pregnancy to help prevent
further problems. The antibiotics will likely relieve your symptoms within a few days, but remember to
complete the entire course of treatment to destroy all of the bacteria.
Bacteria can also multiply in your urinary tract without causing any symptoms (a condition called
asymptomatic bacteriuria), which is why your practitioner sent a sample of your urine to the lab at your
first prenatal visit. You'll need to be treated with antibiotics if you have aymptomatic bacteriuria.
Q2. What do I need to know about bacterial vaginosis during pregnancy?

Bacterial vaginosis (BV) is a genital tract infection is caused by an overgrowth of bacteria that usually
live in small numbers in your vagina. You may not have symptoms with BV. If you do, you may notice a
thin, milky white or gray discharge with a foul or fishy smell. (This odor is most apparent after sex.) You
might also have some irritation or itching around your vagina and vulva, although at least half of all
women with BV have no symptoms.
BV has been linked to an increased risk of preterm labor and preterm rupture of the amniotic
membranes surrounding your baby. If you have symptoms of BV or if you're at risk for preterm labor,
your caregiver will screen for the infection and treat you with antibiotics if the results are positive. If
you're not at risk or don't have any symptoms, your practitioner won't screen you.
Q3. What do I need to know about yeast infections during pregnancy?

Yeast infections are common vaginal infections that are even more likely when you're pregnant. They're
caused by microscopic fungi in the Candida family. These fungi are found in the vaginas of nearly one
third of women and only become a problem when growth is so rapid that the yeast overwhelms other
competing microorganisms. Your increased estrogen level during pregnancy causes your vagina to
produce more glycogen, making it even easier for yeast to grow there. (Some researchers think
estrogen also has a direct effect on yeast, causing it both to grow faster and to stick to the walls of the
vagina better.)
A yeast infection won't hurt your developing baby. If you have an infection when you go into labor,
there's some chance that your newborn will contract it as he passes through the birth canal. Yeast may
cause a common infection called thrush, which is recognizable by white patches in a baby's mouth.
Thrush isn't serious and is easily treated in healthy newborns.
This Week's Activity:

Buy some new bras and undies. If your breasts are sore, get a good supportive cotton bra. Maternity
bras can offer extra support, so try a couple on to see whether you like them. Your breasts might
increase one or two more sizes, especially if this is your first pregnancy, and a knowledgeable sales
associate can help you with sizing. Maternity briefs, bikinis, and even thongs — if that's your thing —
can also make a bigger difference in your comfort than you may realize.
See the big picture

The most dramatic development this week: reflexes. Your baby's fingers will soon begin to open and
close, his toes will curl, his eye muscles will clench, and his mouth will make sucking movements. In
fact, if you prod your abdomen, your baby will squirm in response, although you won't be able to feel it.
His intestines, which have grown so fast that they protrude into the umbilical cord, will start to move into
his abdominal cavity about now, and his kidneys will begin excreting urine into his bladder.
Meanwhile, nerve cells are multiplying rapidly, and in your baby's brain, synapses are forming furiously.
His face looks unquestionably human: His eyes have moved from the sides to the front of his head, and
his ears are right where they should be. From crown to rump, your baby-to-be is just over 2 inches long
(about the size of a lime) and weighs half an ounce.
See what your baby looks like this week. (Or see what fraternal twins look like in the womb this week.)
Note: Every baby develops a little differently, even in the womb. Our information is designed to give you
a general idea of your baby's development.

Your uterus has grown to the point where your healthcare provider can now feel the top of it (the fundus)
low in your abdomen, just above your pubic bone. You may already be into maternity clothes, especially
if this isn't your first pregnancy. If you're still fairly small and not yet ready for maternity clothes, you've
no doubt noticed that your waist is thickening and that you're more comfortable in loose, less restrictive
clothing.
You may begin to feel heartburn (also called acid indigestion), a burning sensation that often extends
from the bottom of your breastbone to your lower throat. Many women get heartburn for the first time
during pregnancy, and those who've previously had bouts of heartburn may find that it gets worse.
During pregnancy, the placenta produces a lot of the hormone progesterone, which relaxes the valve
that separates the esophagus from the stomach. Particularly when you're lying down, gastric acid can
seep back up the pipe, which causes the uncomfortable burning sensation. For many women the
problem doesn't begin (or get worse) until later in pregnancy, when your growing uterus starts to push
up on your stomach. The discomfort may range from mildly annoying to intense and distracting.
Sweet treat
"Instead of your morning coffee, try a cup of steamed milk with a shot of flavored syrup. Delicious — and good for
you and your baby!" —Tracy
Decision Guide: Should you get an amnio?
Amniocentesis is a prenatal test performed between 16 and 20 weeks. It's more than 99 percent
accurate in identifying chromosomal disorders in your developing baby such as Down syndrome. It can
also pick up several hundred other genetic disorders, such as cystic fibrosis, sickle cell disease, and
Tay-Sachs disease, as well as neural tube defects (such as spina bifida and anencephaly). Because
amniocentesis is invasive and carries a small risk of miscarriage, women who choose to have it tend to
be those at increased risk for genetic and chromosomal problems.
How do I decide whether to have this test?

The American College of Obstetricians and Gynecologists now recommends that women of all ages be
offered first- and second-trimester screening and diagnostic testing options. Your practitioner or genetic
counselor should discuss the pros and cons of the available approaches with you. But ultimately,
whether or not to test is a personal decision.
Many women choose screening and then make a decision about diagnostic testing based on the initial
results. Other women choose diagnostic testing right away. (They may know that they're at high risk for
a chromosomal problem or a condition that can't be detected by screening — or they may just feel that
they want to know as much as possible about their baby's condition and are willing to live with the small
risk of miscarriage to find out.) Some women decide to have no screening or testing.
If you choose screening first, you can then decide — with the help of your practitioner or genetic
counselor — whether your results indicate a high enough risk that you want to have amnio or another
diagnostic test, chorionic villus sampling (CVS), to determine whether a problem exists. You'll need to
weigh your desire to know about your baby's condition against the small chance that diagnostic testing
will cause a miscarriage.
What's the procedure like?

If you do decide you want an amnio, you can expect the procedure to take about 30 minutes
(withdrawing the fluid itself usually takes less than 30 seconds). A doctor or technician uses ultrasound
to pinpoint a pocket of amniotic fluid a safe distance from both the baby and the placenta. Then, under
continuous ultrasound guidance, the doctor inserts a long, thin, hollow needle through your abdominal
and uterine walls to extract a small amount of amniotic fluid. You may feel some cramping, pinching, or
pressure during the procedure. The amount of discomfort varies from woman to woman, and even from
pregnancy to pregnancy.
See what other women decided: Did you have an amnio?
Make a baby budget. Sit down with your partner to discuss how you'll handle new-baby expenses —
clothes, food, diapers, toys, and gear can add up fast. Brainstorm where you can trim your budget to
make room for your baby's needs. Consider making some budget adjustments now, and start banking
your savings for your baby.
See the big picture

Fingerprints have formed on your baby's tiny fingertips, her veins and organs are clearly visible through
her still-thin skin, and her body is starting to catch up with her head — which makes up just a third of her
body size now. If you're having a girl, she now has more than 2 million eggs in her ovaries. Your baby is
almost 3 inches long (the size of a medium shrimp) and weighs nearly an ounce.

This is the last week of your first trimester, and your risk of miscarriage is now much lower than earlier in
pregnancy. Next week marks the beginning of your second trimester, a time of relative comfort for many
women who see early pregnancy symptoms such as morning sickness and fatigue subside. More good
news: Many couples also notice a distinct libido lift around this time. Birth is still months away, but your
breasts may have already started making colostrum, the nutrient-rich fluid that feeds your baby for the
first few days after birth, before your milk starts to flow
3 Questions About Eating for two
Q1.
How much more should I be eating every day?
You need only 300 or so extra calories a day when you're pregnant. Make those calories count: Skip the
junk food and have a glass of milk and a couple of slices of whole-wheat toast instead.
Don't get too hung up on numbers, though. As long as you're making healthy food choices and your
provider is happy with your weight gain, there's no need to agonize over calories.
Q2.
What are some important nutrients?
Protein, iron, and calcium are three nutrients you need now to keep you healthy and fuel your baby's
development.
Protein: Aim for 71 grams a day. Lean meats, eggs, and dairy products, as well as nuts, beans, and soy
products like tofu, are all good sources. Three servings a day should help you meet your goal. Fish is a
good source of protein (as well as vital omega-3 fatty acids), but because of concerns about
contamination, experts debate how much and what type of fish you should eat.
Iron: Getting 27 milligrams of iron every day is especially important to help ward off iron-deficiency
anemia, a common problem among pregnant women. Iron found in animal products (called heme iron)
is absorbed more easily by your body than iron found in plants (nonheme iron). The best source? Lean
red meat. If you're a vegetarian or can't stomach meat, you can get some iron from vegetables such as
spinach and legumes like lentils. It can be tough to get enough iron from these sources, though, so your
provider may recommend an iron supplement. (Hint: Vitamin C enhances the absorption of nonheme
iron, so eat foods rich in vitamin C — such as citrus fruits, strawberries, and sweet peppers — at the
same time you eat non-meat iron-rich foods, or down your iron supplement with a glass of orange juice.)
Calcium: Four servings a day of dairy products will help you get the 1,000 mg of calcium you need
(1,300 mg if you're 18 or younger). Your baby needs calcium for the formation of his bones and teeth. If
you don't get enough of this nutrient, he'll take what he needs from your body and you'll lose calcium
stored in your bones.
Q3.
If I'm already taking a prenatal vitamin, do I need to pay much attention to what I eat?
Yes! While a prenatal vitamin can help fill in any nutritional gaps in your diet, it isn't meant to take the
place of healthy eating. For one thing, prenatal vitamins don't have the full day's supply of the calcium
you need right now. For another, it's important to eat plenty of fresh fruits and vegetables for fiber — for
aiding digestion and avoiding constipation, a common pregnancy complaint. In fact, if you're a healthy
woman who's well informed about nutrition, eats a balanced diet, and has no specific risk factors, not all
experts agree that you even need to take a multivitamin and mineral supplement. However, all agree
that you need to take folic acid supplements before conception and during the first trimester, and many
believe it's important to take iron in the second and third trimesters.
• Most healthcare providers recommend taking a vitamin supplement from the time you decide to start
trying to get pregnant through the end your pregnancy. Are you taking a prenatal vitamin?
Share your view of parenting with your partner. To get the conversation going, try this creative
writing exercise: Each of you makes two lists, one titled "My mother always..." and one titled "My mother
never..." Then do the same for "My father always/My father never." When you're done, talk about what
you wrote down and decide together which behaviors you value and which you'd like to change as you
raise your child.
See the big picture

This week's big developments: Your baby can now squint, frown, grimace, pee, and possibly suck his
thumb! Thanks to brain impulses, his facial muscles are getting a workout as his tiny features form one
expression after another. His kidneys are producing urine, which he releases into the amniotic fluid
around him — a process he'll keep up until birth. He can grasp, too, and if you're having an ultrasound
now, you may even catch him sucking his thumb.
In other news: Your baby's stretching out. From head to bottom, he measures 3 1/2 inches — about the
size of a lemon — and he weighs 1 1/2 ounces. His body's growing faster than his head, which now sits
upon a more distinct neck. By the end of this week, his arms will have grown to a length that's in
proportion to the rest of his body. (His legs still have some lengthening to do.) He's starting to develop
an ultra-fine, downy covering of hair, called lanugo, all over his body. Your baby's liver starts making bile
this week — a sign that it's doing its job right — and his spleen starts helping in the production of red
blood cells. Though you can't feel his tiny punches and kicks yet, your little pugilist's hands and feet
(which now measure about 1/2 inch long) are more flexible and active.

Welcome to your second trimester! Your energy is likely returning, your breasts may be feeling less
tender, and your queasiness may have completely abated by now. If not, hang on — chances are good
it will soon be behind you (although an unlucky few will still feel nauseated months from now).
The top of your uterus is a bit above your pubic bone, which may be enough to push your tummy out a
tad. Starting to show can be quite a thrill, giving you and your partner visible evidence of the baby
you've been waiting for. Take some time to plan, daydream, and enjoy this amazing time. It's normal to
worry a bit now and then, but try to focus on taking care of yourself and your baby, and having faith that
you're well equipped for what's ahead.
Decision Guide: Should you find out the sex of your baby?
Boy, girl — or big surprise? Sixty-four percent of mothers-to-be in a BabyCenter poll said they wanted to
find out the sex of their baby ahead of time, while the rest preferred to wait. "We decided that the
surprise of 'it's a boy!' or 'it's a girl!' is the same surprise at 5 months as it is at the birth," said Jessica.
Michael disagreed: "I think the old-fashioned way is the best. Finding out before birth is like opening
your Christmas presents before Christmas!" If you're still on the fence, here's a look at the pros and
cons of each side. A word of caution: If you want to keep your baby's sex a secret, let your provider and
the ultrasound technician know right away so they don't inadvertently blurt it out in the middle of an
ultrasound exam or while reviewing your test results.
Benefits of finding out:

• Many women say they feel a deeper bond with the baby once they know the sex and can picture a little
boy or girl.
• You can prepare an older sibling for the arrival of a new little brother or sister.
• You can narrow down your list of baby names.
• You can pick out a gender-specific nursery theme or baby clothes, if you want to.
Benefits of waiting:
• You, your partner, and your family will have a delightful surprise on the day you give birth.
• Your desire to know whether your baby is a boy or a girl might motivate you during the toughest parts
of labor.
• You'll be following in the tradition of your parents, your parents' parents, and so on.
• There will be no mistakes — what you see is what you get!
Consider keeping the price tags on any baby clothes that are clearly for a boy or a girl until you see your baby for
yourself. Ultrasounds aren't always foolproof at determining sex.
• How has pregnancy affected how often you have sex?
Find a prenatal exercise class. If you haven't already, now is a good time to start a regular workout.
Joining a class can help motivate you to stick with it. And many women find that prenatal exercise
classes are a wonderful way to bond with and get support from other pregnant women. Some good
options include water exercise, prenatal yoga or Pilates, a walking group, or a dance class designed for
pregnant women.
See the big picture

Your growing baby now measures about 4 inches long, crown to rump, and weighs in at about 2 1/2
ounces (about the size of an apple). She's busy moving amniotic fluid through her nose and upper
respiratory tract, which helps the primitive air sacs in her lungs begin to develop. Her legs are growing
longer than her arms now, and she can move all of her joints and limbs. Although her eyelids are still
fused shut, she can sense light. If you shine a flashlight at your tummy, for instance, she's likely to move
away from the beam. There's not much for your baby to taste at this point, but she is forming taste buds.
Finally, if you have an ultrasound this week, you may be able to find out whether your baby's a boy or a
girl! (Don't be too disappointed if it remains a mystery, though. Nailing down your baby's sex depends on
the clarity of the picture and on your baby's position. He or she may be modestly curled up or turned in
such a way as to "hide the goods.")

You've probably gained about 5 pounds by now (a little more or less is fine, too) and are well into the
swing of your pregnancy, but you may still be surprised by an unexpected symptom now and then. If
your nose is stuffed up, for instance, you can probably chalk it up to the combined effect of hormonal
changes and increased blood flow to your mucous membranes. This condition is so common, there's
even a name for it: "rhinitis of pregnancy." Some pregnant women also suffer nosebleeds as a result of
increased blood volume and blood vessel expansion in the nose.
If you're having amniocentesis, it'll most likely happen between now and 18 weeks. This test can identify
hundreds of genetic and chromosomal disorders. If you're getting very anxious while waiting for the
results, it may help to know that most women who undergo amniocentesis get good news about their
babies — bringing welcome relief from their worries.
Don't be surprised if you and your partner are feeling a little stressed out these days. Many pregnant
couples worry about their baby's health and how they'll handle the changes ahead. But with physical
discomforts on the wane and energy on the rise, this is also a wonderful trimester for most women.
Take to the waters "Our community pool offers water aerobics. This is a great way to add some variety to your
workout. I take my older children with me and let them swim while I exercise!" – Heid
3 Questions About Feeling your baby move

Feeling those first flutters and kicks is one of the most amazing experiences of pregnancy. Here's how
much longer you'll have to wait and what to expect when your baby finally gets big and strong enough to
let you know she's in there.
Q1.
When will I first feel my baby move? You'll probably feel your baby move sometime between 16 and
22 weeks, even though she started moving at 7 or 8 weeks and you may have already witnessed her
acrobatics if you've had an ultrasound. Veteran moms tend to notice those first subtle kicks and jabs —
also known as "quickening" — earlier than first-time moms. (A woman who's been pregnant before can
more easily distinguish her baby's movements from other belly rumblings, such as gas.) Your build may
also have something to do with when you'll be able to tell a left jab from a hunger pang. Thinner women
tend to feel movement earlier.
Q2.
What will those first movements feel like? Women have described the sensation as being like
popcorn popping, a goldfish swimming around, butterflies fluttering, a tapping sensation, and bubbles.
You'll probably chalk up those first gentle movements in your belly to gas or hunger pangs, but once you
start feeling them more regularly, you'll recognize the difference. You're more likely to feel these early
movements when you're sitting or lying quietly.
Q3.
When should I worry about my baby's movements? Although your baby is moving around plenty
already, many of his jerks and jolts aren't yet strong enough for you to feel. Later in the second trimester,
his kicks will become stronger and you'll start to feel them regularly. At that point, pay attention to them
and let your practitioner know right away if you notice a decrease in your baby's movement. Less
movement may signal a problem, and you'll need a nonstress test or biophysical profile to check on your
baby's condition. Once you're in your third trimester, some practitioners will recommend that you spend
some time each day counting your baby's kicks.
Talk to your baby. It's a great way to start the bonding process. If having an actual conversation seems
odd to you, narrate your activities; read a book, magazine, or newspaper; or share your secret wishes
for your child. This is great practice for after your baby's born. Talking to babies is one of the best ways
to help them develop language skills.
See the big picture

Get ready for a growth spurt. In the next few weeks, your baby will double his weight and add inches to
his length. Right now, he's about the size of an avocado: 4 1/2 inches long (head to rump) and 3 1/2
ounces. His legs are much more developed, his head is more erect than it has been, and his eyes have
moved closer to the front of his head. His ears are close to their final position, too. The patterning of his
scalp has begun, though his locks aren't recognizable yet. He's even started growing toenails. And
there's a lot happening inside as well. For example, his heart is now pumping about 25 quarts of blood
each day, and this amount will continue to increase as your baby continues to develop.

The top of your uterus is about halfway between your pubic bone and your navel, and the round
ligaments that support it are thickening and stretching as it grows. You're probably feeling a whole lot
better as you settle into pregnancy, too. Less nausea, fewer mood swings, and "glowing" skin contribute
to an overall sense of well-being.
Soon you'll experience one of the most wonderful moments of pregnancy — feeling your baby move.
While some women notice "quickening" as early as 16 weeks, many don't feel their baby move until
about 18 weeks or more. (And if this is your first baby, don't be too impatient — you may not be aware of
your baby's movements until 20 weeks or so.) The earliest movements may feel like little flutters, gas
bubbles, or even like popcorn popping. Over the following weeks they'll grow stronger and you'll be able
to feel them much more frequently.
Feel your baby move "I wasn't sure if I could feel my baby moving, so a friend suggested I lie down for a while. After
a few minutes, I started feeling a butterfly sensation in my lower abdomen. It was amazing!" — Linda B.
3 Questions About...Gaining weight
Q1.
How much weight should I gain now?
Aim to gain about 12 to 14 pounds this trimester (toward a total of 25 to 35 for your whole pregnancy) if
you started your pregnancy at an average weight. Your caregiver may advise that you gain a little more
or less if you started your pregnancy over- or underweight or you're carrying twins or more.
Q2.
How can I keep my weight gain on track? During pregnancy, most women need to eat about 300
calories a day more than their usual daily intake. (The total amount of calories you'll need depends on
your weight and activity level.)
If you're gaining too much: Some women find that they're gaining weight too quickly. It's not a good
idea to go on a low-calorie diet or skip meals during pregnancy, though. Instead, try these suggestions
to help slow your weight gain:
• Start your day with a nutritious breakfast that includes adequate protein, complex carbohydrates, fiber,
and a small amount of healthy fat.
• Eat vegetables, whole grains, lean meat, and low-fat dairy products, and skip processed foods,
packaged snacks, and sugar-loaded desserts.
• Keep healthy, filling snacks around, such as low-fat cheese and yogurt, baby carrots, and fresh fruit
such as apples or bananas. You'll be less susceptible to junk-food snack attacks.
• Choose a tasty alternative to a fatty food. For example: Nonfat frozen yogurt instead of ice cream, a
bagel instead of a doughnut, or air-popped popcorn instead of potato chips. (Get more ideas.
• Drink water instead of reaching for a glass of juice.
• With your caregiver's okay, get regular exercise. If you have trouble getting started or keeping to a
routine, find an exercise buddy who'll go for a daily walk or swim with you. This will help to keep you
motivated. Even a 20-minute daily walk at lunchtime will make a difference.
If you're having a hard time gaining enough: Some women find themselves struggling to budge the
scale. Here are a few tips to help you put on the pounds:
• Drink a milk shake every day (add in fresh fruit for vitamin C). You'll get a calorie boost and you'll
benefit from the calcium in the ice cream.
• Eat nutrient-dense foods with good fats, such as avocados and nuts.
• Try eating dried fruit. It's not as filling as fresh fruit, so you tend to eat more of it and pack in more
healthy calories. • In addition to your meals, eat frequent snacks.
• Remind yourself that you're supposed to be putting on weight now, for yourself and for your baby's
well-being. Then chow down!
Q3.
How will the weight I gain during pregnancy affect my body? At least some of the aches and pains
you'll feel as pregnancy progresses are related to your changing body shape and the increasing weight
of your womb. Backaches are common, and you may begin to feel more clumsy and prone to falls.
Expect your skin to stretch, too, as your belly and breasts expand, which may result in stretch marks.
You may be most worried about whether you'll be able to shed all your "baby fat" after your baby's born.
It may take a while, but if you eat right and exercise you'll most likely get rid of the pounds eventually.
You'll have an easier time getting back in shape if you're active now.
• It's easy to obsess about your weight during pregnancy, especially if you're having a hard time staying
within the 25- to 35-pound gain recommended for most women of normal weight. How's it going for you?
Plan a romantic getaway — even if you stay home. Once your baby arrives, it will be very hard for
you and your partner to slip away for a weekend alone. Don't miss this chance to kick back together.
And don't wait much longer because by your third trimester you may feel too tired and achy to hit the
road. If you can't get out of town, plan local activities you can enjoy together — even dinner and a movie
counts
See the big picture

Your baby's skeleton is changing from soft cartilage to bone, and the umbilical cord — her lifeline to the
placenta — is growing stronger and thicker. Your baby weighs 5 ounces now (about as much as a
turnip), and she's around 5 inches long from head to bottom. She can move her joints, and her sweat
glands are starting to develop.

Starting to feel a bit off balance? As your belly grows, your center of gravity changes, so you may begin
to occasionally feel a little unsteady on your feet. Try to avoid situations with a high risk of falling. Wear
low-heeled shoes to reduce your risk of taking a tumble; trauma to your abdomen could be dangerous
for you and your baby. You'll also want to be sure to buckle up when you're in a car — keep the lap
portion of the seat belt under your belly, drawn snugly across your hips, and also use the shoulder
harness, which should fit snugly between your breasts.
You may also notice your eyes becoming drier. Using over-the-counter lubricating drops may help. If
your contact lenses become uncomfortable, try wearing them for shorter stretches of time. If you still
have discomfort, switch to glasses until after you give birth.
An easy way to keep track of the nutrients you need "I made a simple chart of the basic food groups and posted it
on the refrigerator. At the end of the day, I checked off what I had eaten. Then, for my bedtime snack, I tried to pick
something that would fulfill whatever category was lacking — yogurt (or a bowl of ice cream!) if I needed more dairy,
for example, or an orange if I needed more fruit." — Anonymous
Dreams During Pregnancy

Many women report that their dream life shifts into high gear during pregnancy. Interestingly, during the
second and third trimesters, you spend less sleep time in rapid eye movement (REM) sleep, the cycle in
which most dreams occur. Why, then, all those frequent and vivid dream memories?
It's probably at least in part because you may be interrupting a dream-filled cycle when you wake up to
pee, cope with heartburn, leg cramps, restless legs, or a backache, or to shift to a more comfortable
position. Waking up during REM sleep makes you more likely to remember your dreams.
It may also be in part that dreams seem so vivid during pregnancy because for most women pregnancy
is a time of such heightened emotions — from joy to apprehension and everything in between — but no
one really knows for sure.
Here's a look at some common themes and what they may mean, according to Patricia Garfield, a
clinical psychologist and author of Women's Bodies, Women's Dreams.
You're caring for baby animals. During the second trimester, many pregnant women dream about
cuddly, baby-like animals, such as puppies, chicks, and kittens. Friendly creatures in your dreams are
generally thought to signify that you're tuned in to your instincts. Menacing animals, on the other hand,
may represent ambivalence about the strange new creature entering your life.
You have a sexy encounter with an old flame. Many mothers-to-be are concerned about their
changing figure and its effect on their sex life — while many others feel more sexually charged than
ever. Both feelings are often reflected in your dreams. Not only do erotic dreams offer comforting
reassurance, but they may mirror the sexiness you feel during your waking hours, too.
Your mate is straying. If you dream that your partner hooks up with an ex-girlfriend or a total stranger,
it can signal insecurity about holding his love and attention through a time of great change. Right now,
you're dependent on the goodwill and support of those around you, especially your partner. Fearing his
loss is a common emotional reaction to being pregnant.
Since there's nothing you can do to stop the crazy dreams, try having fun with them. Keep a notebook and pen by
your bedside to jot them down.
Start a baby name list. Make a list of ten names you like. Have your partner do the same. Trade lists
and each cross out one name on the other's list that you dislike. Keep taking turns until you have a set
of names you can both live with. Talk about why you like and dislike certain names. Many couples even
create ground rules, such as no names of former girlfriends or boyfriends and no names that have ever
been used for family pets.
See the big picture

Head to rump, your baby is about 5 1/2 inches long (about the length of a bell pepper) and he weighs
almost 7 ounces. He's busy flexing his arms and legs — movements that you'll start noticing more and
more in the weeks ahead. His blood vessels are visible through his thin skin, and his ears are now in
their final position, although they're still standing out from his head a bit. A protective covering of myelin
is beginning to form around his nerves, a process that will continue for a year after he's born. If you're
having a girl, her uterus and fallopian tubes are formed and in place. If you're having a boy, his genitals
are noticeable now, but he may hide them from you during an ultrasound.

Hungry? An increase in appetite is pretty common about now. Make it count by choosing meals and
snacks that are rich in nutrients instead of empty calories (chips, French fries, candy, and other sweets).
Bigger, more comfortable clothes are a must now as your appetite and waistline grow.
Your cardiovascular system is undergoing dramatic changes, and during this trimester your blood
pressure will probably be lower than usual. Don't spring up too fast from a lying or sitting position or you
might feel a little dizzy.
From now on, when you do lie down, it's best to lie on your side — or at least partly tilted to one side.
(When you lie flat on your back, your uterus can compress a major vein, leading to decreased blood
return to your heart.) Try placing a pillow behind you or under your hip or upper leg for comfort.
If you haven't already had a second-trimester ultrasound, you'll probably have one soon. This painless
procedure helps your practitioner check how your baby's growing, screen for certain birth defects, check
the placenta and umbilical cord, determine whether the due date you're working with is accurate, and
see how many babies you're carrying. During the exam, you might see your baby moving around or
sucking his thumb. Bring your partner along, and be sure to ask for a printout for your baby's first photo
album!
Afternoon energy booster "If you're finding it hard to get through the afternoon at work without a little nap, find a
place you can escape for 15 to 20 minutes (close your office door, use a conference room, even sit in your car). Bring
a small travel alarm clock and set it for 15 minutes." — Laura
3 Questions About...How to exercise now
Q1.
Should I change my fitness routine?
In most cases, if you're healthy and your pregnancy is proceeding normally, you can continue working
out as you did in your first trimester — with some sensible modifications to accommodate your growing
belly. What to do: Stick to a moderate level of exercise and avoid bouncing and jarring motions, sudden
changes of position, and lying on your back.
Q2.
I've been pretty sedentary, but I'd like to start getting some exercise. Where should I start?
First, check in with your caregiver about your plans. Then, you'll need to start with gentle exercise for
short periods of time (about 15 minutes a few times per week) and gradually work up to a longer and
more intense daily routine (about half an hour a day). What to do: Walking is the easiest way to get
started on a regular fitness program, and it doesn't require any special equipment other than a good pair
of walking shoes! Many women enjoy swimming during pregnancy because the water helps hold up
their extra weight. Others swear by prenatal yoga to stretch and strengthen their body as well as relieve
aches and pains.
Q3.
What are Kegels?
Kegels are exercises that strengthen the muscles of your pelvic floor — the ones that support your
urethra, bladder, uterus, vagina, and rectum. Kegels help prevent urine leaks during and after
pregnancy and may even help you in the second stage of labor. What's more, Kegels increase
circulation to your rectal and vaginal area, so they may help keep hemorrhoids at bay and speed healing
after childbirth if you receive stitches.
Here's how to do them:

• Tighten the muscles around your vagina as if trying to interrupt the flow of urine when going to the
bathroom. Use a "squeeze and lift" technique, working only your pelvic floor muscles while keeping your
abdominal and leg muscles relaxed. And be sure not to hold your breath.
• Hold for about eight to ten seconds, then release. Do them in sets of ten, and try to work up to three or
four sets a day.
Look into childbirth classes. The best and most popular ones fill up fast so start your search now.
Classes vary quite a bit in their approach. Some are spread out over several weeks, while others are as
short as a day. Your hospital probably offers classes, but you may want to take a specialized class
elsewhere. To find a class, get recommendations from your healthcare provider and your friends, or call
the International Childbirth Education Association at (952) 854-8660 for information about childbirth
educators in your area.
See the big picture

Your baby's sensory development is exploding! Her brain is designating specialized areas for smell,
taste, hearing, vision, and touch. Some research suggests that she may be able to hear your voice now,
so don't be shy about reading aloud, talking to her, or singing a happy tune if the mood strikes you.
Your baby weighs about 8 1/2 ounces and measures 6 inches, head to bottom — about the size of a
large heirloom tomato. Her arms and legs are in the right proportions to each other and the rest of her
body now. Her kidneys continue to make urine and the hair on her scalp is sprouting. A waxy protective
coating called the vernix caseosa is forming on her skin to prevent it from pickling in the amniotic fluid.

Think you're big now? You'll start growing even faster in the weeks to come. As a result, you may notice
some achiness in your lower abdomen or even an occasional brief, stabbing pain on one or both sides
— especially when you shift position or at the end of an active day. Most likely, this is round ligament
pain. The ligaments that support your uterus are stretching to accommodate its increasing weight. This
is nothing to be alarmed about, but call your practitioner if the pain continues even when you're resting
or becomes severe.
You may be noticing some skin changes, too. Are the palms of your hands red? Nothing to worry about
— it's from the extra estrogen. You may also have patches of darkened skin caused by a temporary
increase in pigment. When these darker patches appear on your upper lip, cheeks, and forehead,
they're called chloasma, or the "mask of pregnancy." You may also notice some darkening of your
nipples, freckles, scars, underarms, inner thighs, and vulva. That darkened line running from your belly
button to your pubic bone is called the linea nigra, or "dark line."
These darkened spots will probably fade shortly after delivery. In the meantime, protect yourself from the
sun, which intensifies the pigment changes. Cover up, wear a brimmed hat, and use sunscreen when
you're outdoors. And if you're self-conscious about your "mask," a little concealing makeup can work
wonders.
Soothe aching muscles "Try gently massaging your achy ligaments, or use a heating pad or warm facecloth where
it hurts." — Anonymous
Decision Guide: Naming your baby
For many couples, settling on a name for their baby is a lot of fun. For others, it's a tortuous process of
negotiation. Either way, it's an important decision because you're choosing something that will last a
lifetime (unless your little one decides to rename herself along the way). Here are some factors to
consider when you're deciding on a name:
• Sound and compatibility How your baby's name sounds when it's said aloud is one of the most
essential things to think about. Is it melodious? Harsh? Does it go well with your last name? One thing to
avoid: Choosing a first name that ends in the same sound as the beginning of your last name.
• Uniqueness An unusual name has the advantage of making your child stand out from the crowd. On
the other hand, a name no one has heard of and few can pronounce can bring attention your child might
rather avoid. Spelling variations can help make a name unique, but choosing a name with numerous
spellings can cause confusion in your child's life for years to come.
• Relatives and friends Many parents choose to name their babies after a grandparent, another
relative, or a close friend. Don't want too many Michaels in your house? Look way back in your family
tree for hidden treasures. And if you're worried about hurt feelings, consider a first name from one side
of the family and a middle name from the other. According to a BabyCenter survey, middle names are a
must for most parents; 98 percent give their child a middle name, with 7 percent of those parents giving
their child two or more middle names.
• Ancestry and heritage Your child's heritage is an essential part of who she is, and you may want her
name to reflect that. Skim history books focusing on your family's country of origin to find appropriate
possibilities.
• Meaning No one is likely to treat your daughter Ingrid differently because her name means "hero's
daughter," but the derivation of your baby's name is something you may want to think about. Use
BabyCenter's Baby Name tool to learn the meaning of over 5,000 names.
• Initials and nicknames People, especially kids, can be cruel when it comes to nicknames, so try to
anticipate any potentially embarrassing ones. Consider your child's initials as well, so you don't
inadvertently saddle her with a doozy like Z.I.T. or P.E.E.
One of the best tests for a baby name is to yell it out loud, preferably at a playground. If you feel uncomfortable
saying the name in that setting, it might not be the best choice.
• Many people going through pregnancy like to refer to their growing baby by name — or nickname.
What about you?
This Week's Activity
Start your childcare search. It may seem early to you, but the best centers often have long waiting
lists and it's easier to go on tours now than when you have an infant in tow. You have many options, so
review the pluses and minuses of daycare centers, nanny care, home daycare, and relative care. Put
your name on a few lists even if you aren't sure what you'll do. When the time comes, you may be
grateful for the options

See the big picture

Your baby weighs about 10 1/2 ounces now. He's also around 6 1/2 inches long from head to bottom
and about 10 inches from head to heel — the length of a banana. (For the first 20 weeks, when a baby's
legs are curled up against his torso and hard to measure, measurements are taken from the top of his
head to his bottom — the "crown to rump" measurement. After 20 weeks, he's measured from head to
toe.)
He's swallowing more these days, which is good practice for his digestive system. He's also producing
meconium, a black, sticky by-product of digestion. This gooey substance will accumulate in his bowels,
and you'll see it in his first soiled diaper (some babies pass meconium in the womb or during delivery).

Congratulations! You've hit the halfway mark in your pregnancy. The top of your uterus is about level
with your belly button, and you've likely gained around 10 pounds. Expect to gain another pound or so
each week from now on. (If you started your pregnancy underweight, you may need to gain a bit more; if
you were overweight, perhaps a bit less.) Make sure you're getting enough iron, a mineral that's used
primarily to make hemoglobin (the part of your red blood cells that carries oxygen). During pregnancy,
your body needs more iron to keep up with your expanding blood volume, as well as for your growing
baby and the placenta. Red meat is one of the best sources of iron for pregnant women. Poultry
(especially the dark meat) and shellfish also contain iron. Some common non-meat sources of iron
include legumes, soy-based products, spinach, prune juice, raisins, and iron-fortified cereals.
If you haven't already signed up for a childbirth education class, you may want to look into one,
especially if you're a first-timer. A structured class will help prepare you and your partner for the rigors of
labor and delivery. Most hospitals and birth centers offer classes, either as weekly meetings or as a
single intensive, one-day session. Many communities have independent instructors as well. Ask your
friends, family members, or caregiver for recommendations.
Take an extra pillow to bed tonight "I found it so much easier to sleep on my side when I hugged a pillow and
wrapped my legs around it. In fact, two years after the birth of my child, it's still my favorite way to fall asleep." —
Clara
Surprising Facts: Getting a good night's rest
It may become more difficult to sleep through the night as your pregnancy progresses, thanks to some
obvious and not-so-obvious changes taking place in your body. You may be surprised to find that:
• You start snoring for the first time in your life, thanks in part to more estrogen, which contributes to
swelling of the mucous membranes that line the nose and may even cause you to make more mucus.
What to do: Sleep on your side and elevate your head slightly.
• Heartburn and indigestion can make it extra uncomfortable to lie down in bed. What to do: Avoid foods
that trigger your heartburn, give yourself two to three hours to digest a meal before going to bed, and try
sleeping semi-upright in a comfy recliner or propped up with extra pillows under your upper body.
• Leg cramps jar you out of a deep sleep. What to do: Ease the cramp by straightening your leg, heel
first and gently flexing your toes back toward your shins, or walk around for a few minutes.
• You toss and turn all night trying to find a comfortable sleeping position. What to do: Lie on your side
with your knees bent and a pillow between your legs. For extra comfort and support, arrange other
pillows under your belly and behind your back. Or try using a contoured maternity body pillow.
• You become hot and sweaty in the middle of the night. It's common for pregnant women to feel a little
warmer than usual thanks to shifts in your metabolism, hormones, and weight. What to do: Keep your
bedroom cool and strip down to the bare essentials. Keep slippers and a snuggly bathrobe handy for
those nighttime trips to the bathroom.
• Getting out of bed is harder than ever! What to do: Roll over onto your side so you're facing the edge
of the bed. Dangle your legs over the side and use your arms to push yourself into a sitting position.
Plant your feet squarely on the floor and then stand up.
Wear sleepwear made of a natural, breathable fiber like cotton. Avoid synthetics, which trap moisture next to your
skin and can leave you damp and chilled.
• Sometimes even when you're exhausted, you just can't sleep. So do you toss and turn waiting for
sleep to catch up with you — or do something else in the meantime? Take our poll.
Treat yourself to something nice. You've made it to the halfway mark in your pregnancy, so celebrate
with a little indulgence. Need some ideas?
• For your comfort, try scented candles, a new nightgown or pajamas, or a prenatal massage.
• For a keepsake, splurge on professional pictures of your pregnant self, or a beautiful frame for your
baby's first picture after birth. (In the meantime, you can use an ultrasound picture!)
• To feel like a hot momma, buy yourself a piece of clothing that makes you feel really sexy or get a free
makeover at a department store.
See the big picture

Your baby now weighs about three-quarters of a pound and is approximately 10 1/2 inches long — the
length of a carrot. You may soon feel like she's practicing martial arts as her initial fluttering movements
turn into full-fledged kicks and nudges. You may also discover a pattern to her activity as you get to
know her better. In other developments, your baby's eyebrows and lids are present now, and if you're
having a girl, her vagina has begun to form as well.

You're probably feeling pretty comfortable these days. You're not too big yet, and the usual discomforts
associated with early pregnancy are, for the most part, gone. If you're feeling good, relax and enjoy it
while you can — the third trimester may bring with it a new crop of complaints.
That's not to say you won't have some minor glitches to deal with now. For example, increased oil
production may contribute to the development (or worsening) of acne. If that's the case, be diligent
about washing well with a gentle soap or cleanser twice a day, and make sure that any moisturizer or
make-up you use is oil-free. Don't take any oral acne medications — some are very hazardous during
pregnancy — or use any topical acne products without first checking with your practitioner.
You're also more prone to varicose veins now. As your pregnancy progresses, there's increasing
pressure on the veins in your legs; higher progesterone levels, which may cause the walls of your veins
to relax, can make the problem worse. You're more likely to get varicose veins if other family members
have them. Also, they tend to get worse with each successive pregnancy and as you age. To help
prevent or minimize varicose veins, exercise daily, prop up your feet and legs whenever possible, sleep
on your left side, and wear maternity support hose.
You may also notice so-called spider veins (a group of tiny blood vessels near the surface of your skin),
particularly on your ankles, legs, or face. They may have a spider- or sunburst-like pattern with little
branches radiating out from the center, they may look like the branches of a tree, or they may be a
group of separate thin lines with no particular pattern. Though they may be a bit unsightly, spider veins
don't cause discomfort and usually disappear after delivery.
Hit the garage sales "I saved a ton of money on baby gear, nursery furniture, and toys by going to garage sales a
few months before my baby was due. Many of the items I found were as good as new!" — Becca
3 Questions About...Sex during pregnancy
Q1.
Is it normal to crave sex during pregnancy?
Some pregnant women feel their sexual desire skyrocket when they're pregnant, at least part of the
time. They may enjoy the increased blood flow to the pelvic area and the heightened sensitivity to
stimulation that this brings, as well as the increased vaginal lubrication due to hormonal changes. Said
one BabyCenter mom-to-be, "Hormones have turned me into a sex machine! I seem to want it more and
more lately."
But it's also completely normal not to crave sex. If you're having lots of aches and pains or feeling
unattractive or just plain tired, your libido may take a nosedive. "I have no desire to be intimate with my
husband. It's just that I'm tired all the time and uncomfortable in pretty much every position," reports
another pregnant mom.
If you don't feel up to having intercourse, let your partner know how you feel and reassure him that you
still love him. It's crucial to keep the lines of communication open and to support each other as best you
can as you go through these changes together. And remember that there's more to physical intimacy
than sex. You can still hug, kiss, and caress each other.
Q2.
What positions are most comfortable now?
More than 75 percent of Baby Center parents-to-be who responded to a poll said they experimented
with different lovemaking positions during pregnancy. Having intercourse side-by-side was a favorite for
many. Some other positions to try:
• Straddle your partner as he lies on his back or sits on a sturdy chair. This way, there'll be no weight on
your abdomen and you can control the depth of penetration.
• Support yourself on your knees and elbows. Have your partner kneel and enter you from the rear.
Q3.
Is sex ever off-limits during pregnancy?
You'll need to abstain if you have any of the following conditions or symptoms:
• placenta previa
• premature labor in this pregnancy
• unexplained vaginal bleeding or discharge
• abdominal cramping
• cervical insufficiency
• a dilated cervix
• your water has broken, even if you're just leaking a bit
You'll also need to abstain if you or your partner has an outbreak of genital herpes or feel one coming
on. Avoid intercourse and other genital contact for the entire third trimester if your partner has a history
of genital herpes (and you don't), even if he has no sores or symptoms. The same applies to receiving
oral sex if he has oral herpes (cold sores). Finally, don't have sex if you or your partner has any other
sexually transmitted infection unless you've both been treated and follow-up testing was negative.
There are other situations in which your healthcare practitioner may advise you not to have sex. For
example, if you had a spontaneous preterm birth in a previous pregnancy, she'll probably advise you to
stop having sex at some point during this pregnancy and continue to abstain until you reach 37 weeks.
Create a baby registry. Even if you don't like the idea of asking for specific gifts, family and friends will
soon be asking what you need or want — particularly if someone's throwing you a baby shower. If you
prepare a gift registry, you'll know exactly what to tell them. Two common mistakes to avoid:
• Registering for clothing. Don't waste your time: People can't resist buying baby clothes, and they
generally pick out what they think is cute.
• Not registering for big ticket or expensive items. Don't worry: You won't be seen as greedy. Many
shower guests like to go in on a "big gift" together, so give them something to sink their teeth into.
See the big picture

At 11 inches (the length of a spaghetti squash) and almost 1 pound, your baby is starting to look like a
miniature newborn. His lips, eyelids, and eyebrows are becoming more distinct, and he's even
developing tiny tooth buds beneath his gums. His eyes have formed, but his irises (the colored part of
the eye) still lack pigment. If you could see inside your womb, you'd be able to spot the fine hair (lanugo)
that covers his body and the deep wrinkles on his skin, which he'll sport until he adds a padding of fat to
fill them in. Inside his belly, his pancreas — essential for the production of some important hormones —
is developing steadily.

At this point, you may find your belly becoming a hand magnet. It's perfectly okay to tell folks who touch
your tummy that you'd rather they didn't. And if people are telling you that you look smaller or bigger
than you should at this point, remember that each woman grows — and shows — at her own rate.
What's important is that you see your practitioner for regular visits so she can make sure your baby's
growth is on track.
You may start to notice stretch marks on your abdomen as it expands to accommodate your growing
baby. At least half of all pregnant women will develop stretch marks by the time they give birth. These
small streaks of differently textured skin can range from pink to dark brown (depending on your skin
color). Although they most commonly appear on your tummy, stretch marks may also show up on your
buttocks, thighs, hips, and breasts. There's no proof that lotion helps prevent stretch marks, but keeping
your skin moisturized may help with any itching.
Write it down "I kept a journal for my son while I was pregnant, and I brought it to the hospital with me so I could
write in it as soon as I was up to it. It really helped to share all the feelings I was having." — Anonymous
Surprising Facts: Body changes beyond your belly

You expected your belly to grow — and perhaps your breasts, too — but the following physical changes
may take you by surprise. As with many pregnancy changes, hormones play a role in most of these
alterations in your looks.
• Thicker, more lustrous hair You're not actually growing more hair, just losing less than normal.
During pregnancy, your body sheds hair much more slowly than it did before. What to do: If thicker hair
is a boon for you, enjoy it. If it's making your mane more unruly than ever, ask your stylist to do some
thinning at your next cut. These changes won't last forever. After your baby's born, you'll start to lose this
excess hair, sometimes in clumps.
• Increased body hair Sex hormones known as androgens can cause new hair to sprout on your chin,
upper lip, jaw, and cheeks. Stray hairs can also pop up on your belly, arms, legs, and back. What to do:
Tweezing, waxing, and shaving are all safe ways to manage these temporary changes.
• Faster-growing fingernails Your fingernails may grow more quickly than usual, and you may notice
changes in texture. Some women's nails get harder, while others' get softer or more brittle. What to do:
Protect your nails by wearing rubber gloves when you're cleaning, and using moisturizer on them if
they're brittle.
• Skin changes Some pregnant women report that their skin has never looked better. If that's you, enjoy
the proverbial "glow." Others find the hormones of pregnancy aggravate skin conditions such as acne.
What to do: Wash twice a day with a gentle soap or cleanser, and make sure that any moisturizer or
makeup you use is oil-free.
• Stretch marks As your belly expands to accommodate your growing baby, you may get tiny tears in
the supportive tissue that lies just beneath your skin, resulting in striations of varying color. These marks
will begin to fade and become considerably less noticeable about six to 12 months after you give birth.
There's not much you can do besides trying not to gain more than the recommended amount of weight.
Heredity is responsible for the natural elasticity of your skin and plays a role in determining who will end
up with stretch marks.
• Skin discolorations Increased melanin can cause splotchy patches of darkened skin on your face.
These pigment changes may become intensified if you spend time in the sun. What to do: Protect your
face by using a sunblock that offers both UVA and UVB protection with an SPF of 30 or higher, wearing
a hat with a brim, and avoiding the sun during peak hours of the day (10 a.m. to 2 p.m.).
• Larger and darker nipples and areolas You may find that your nipples and the pigmented area
around them (the areolas) are getting bigger and darker. The little bumps on your areolas, known as
Montgomery's tubercles, may also be more pronounced. These bumps are oil-producing glands that
help fight off bacteria and lubricate the skin. Some women also notice more pronounced veins in their
breasts. What to do: Nothing!
• Larger feet Your feet may go up half a shoe size or more. Lax ligaments may make your feet spread a
bit — permanently. Swelling can make your shoes feel tight as well, although it will go away after
delivery. What to do: Buy comfortable shoes to accommodate your growing feet.
Check out your rings. It's common to have some swelling in your fingers as your pregnancy
progresses. If your rings are feeling the least bit snug, do yourself a favor and take them off now before
it's too late (or at least keep an eye on them). If you can't bear to be separated from your wedding band
or another important ring when you can no longer sport it on your finger, loop it on a chain and wear it
close to your heart.

See the big picture

Turn on the radio and sway to the music. With her sense of movement well developed by now, your
baby can feel you dance. And now that she's more than 11 inches long and weighs just over a pound
(about as much as a large mango), you may be able to see her squirm underneath your clothes. Blood
vessels in her lungs are developing to prepare for breathing, and the sounds that your baby's
increasingly keen ears pick up are preparing her for entry into the outside world. Loud noises that
become familiar now — such as your dog barking or the roar of the vacuum cleaner — probably won't
faze her when she hears them outside the womb.
You may notice that your ankles and feet start to swell a bit in the coming weeks or months, especially
at the end of the day or during the heat of summer. Sluggish circulation in your legs — coupled with
changes in your blood chemistry that may cause some water retention — may result in swelling, also
known as edema. Your body will get rid of the extra fluid after you have your baby, which is why you'll
pee frequently and sweat a lot for a few days after delivery. In the meantime, lie on your left side or put
your feet up when you can, stretch out your legs when you sit, and avoid sitting — or standing — in one
place for long periods. Also, try to exercise regularly to increase circulation, and wear support stockings
(put them on first thing in the morning) and roomy, comfortable shoes. You may be tempted to skimp on
liquids to combat swelling, but you need to drink plenty of water because staying hydrated actually helps
prevent fluid retention. While a certain amount of edema in your lower extremities is normal during
pregnancy, excessive swelling may be a sign of a serious condition called preeclampsia. Be sure to call
your midwife or doctor if you have severe or sudden swelling of your feet or ankles, more than slight
swelling of your hands, swelling in your face, or puffiness around your eyes.
Exercise helps you sleep "When I started having trouble sleeping during my pregnancy, I asked my friends what to
do. One suggested I take a half-hour walk during the day. It really helped me sleep better, and it felt great to have a
little time for myself." — Linda
Decision Guide: Should you bank your baby's cord blood?
Cord blood banking is a procedure in which the blood left in your baby's umbilical cord and placenta
after birth is collected, frozen, and stored for future medical use. Cord blood is prized because it's a rich
source of stem cells — the building blocks of the blood and immune system. Stem cells have the ability
to differentiate into other tissues, and cord blood can be used to treat a host of diseases, including
leukemia and sickle cell anemia. Only you can decide whether banking your baby's cord blood is right
for your family. Factors to consider:
• Cord blood research is showing promising preliminary results.

Studies are under way around the world, and many researchers are optimistic about the future. For
instance, cord blood researchers believe that one day some adult cancer patients may benefit from their
own cord blood stem cells that were harvested at birth. The hope is that stem cells could be used to
treat cancers that aren't genetically based.
In light of recent animal experiments, many researchers also believe that cord blood will eventually be
used to treat diabetes, spinal cord injuries, heart failure, stroke, and serious neurological diseases.
However, many experts caution parents to take such studies (especially those conducted on animals)
with a grain of salt, because it's difficult to predict when, if ever, these treatments will become available
for humans. The March of Dimes, a nonprofit organization dedicated to improving the health of babies,
sums it up this way: "The use of umbilical cord blood stem cells for transplantation treatment holds
exciting promise, but this area of medical science is still largely investigational."
• It's expensive.
Private cord blood banks usually charge an enrollment and collection fee of about $2,000 or so, plus
annual storage fees around $125.
• Chances are that your baby cannot be treated with his own cord blood.
If your child has or develops an illness with a genetic basis — which is often the case with conditions
that could benefit from a cord blood transplant — his cord blood contains the genetic instructions for that
disease, so it's not a suitable treatment. Most banked cord blood is currently used to treat siblings.
• You probably have a better chance of finding a stem cell match in the public cord blood system
than in your own family.
The chance of an exact tissue match between two siblings is only about 25 percent, according to Dennis
Confer, chief medical officer for the National Marrow Donor Program, a nonprofit organization that
maintains the largest public listing of umbilical cord blood units available for transplantation in the United
States. In contrast, the chance of finding a cord blood match in the nation's public banks is 75 percent,
he says.
• Doctors aren't ready to universally recommend banking your baby's cord blood.
The American Academy of Pediatrics and some other experts have expressed reservations about
private cord blood banking for the general public because they believe the chances a family will ever
need the blood are slim and because they support a public cord blood donation system (similar to blood
banks). However, cord blood banking is encouraged when there's an immediate family member who's
already been diagnosed with a condition that may be treated with cord blood transplantation. (In this
situation, you may be eligible for a special cord blood banking program called "The Sibling Connection,"
in which your baby's cord blood will be collected, processed, and stored for five years at no cost to you.
Call 866-861-8435 for more information.)
• If your child belongs to a minority group, private storage may be of more value to you.
According to July 2003 figures, a Caucasian patient has an 88 percent chance of finding a matching
donor through the registry of the National Marrow Donor Program, while an African American's chances
were significantly lower at 58 percent.
• For more information, see:

Cord blood banking: An overview
Private cord blood banking: Is it for you?
Finding a reputable private cord blood bank
Donating your baby's cord blood
If you decide you want to bank your baby's cord blood, talk to your caregiver and start researching both the public
and private banking options now. Most private cord blood banks prefer women to sign up during the second trimester.
If you wait too long, you may have to pay late enrollment fees.
Write a letter to your baby. You and your child will treasure this gift for years to come. Go with your
heart and follow your inspiration. If you need help getting started:
• Describe your feelings toward your baby and what it's like to know she's growing inside you.
• Imagine a perfect day with your baby and what you'll do together.
• Write down your hopes, dreams, and wishes for your baby.
• Think about what being a mother means to you and your definition of what makes a good mother.
If writing isn't your style, put together a collage or a memory box of pregnancy mementos, says Diane
Sanford, a clinical psychologist whose focus is on helping women make the transition to motherhood.
See the big picture

Your baby's growing steadily, having gained about 4 ounces since last week. That puts him at just over a
pound. Since he's almost a foot long (picture an ear of corn), he cuts a pretty lean figure at this point,
but his body is filling out proportionally and he'll soon start to plump up. His brain is also growing quickly
now, and his taste buds are continuing to develop. His lungs are developing "branches" of the
respiratory "tree" as well as cells that produce surfactant, a substance that will help his air sacs inflate
once he hits the outside world. His skin is still thin and translucent, but that will start to change soon.

In the past few weeks, the top of your uterus has risen above your belly button and is now about the
size of a soccer ball.
Most women have a glucose screening test (also called a glucose challenge test or GCT) between now
and 28 weeks. This test checks for gestational diabetes, a pregnancy-related high-blood-sugar
condition. Untreated diabetes increases your risk of having a difficult vaginal delivery or needing a
cesarean section because it causes your baby to grow too large, especially in his upper body. It also
raises your baby's odds for other complications like low blood sugar right after birth. A positive result on
your GCT doesn't mean you have gestational diabetes, but it does mean that you'll need to take the
glucose tolerance test (GTT) to find out for sure.
Finally, if you don't already know how to spot the signs of preterm labor, now's the time to learn. Contact
your caregiver immediately if you notice any of the signs mentioned below.
Relief for finger pain "To relieve finger pain and swelling, I keep a cold pack in the freezer. I apply it to my hands
several times a day." — Kate
3 Questions About...Preterm labor
More than 12 percent of babies in the United States are born prematurely (before 37 weeks). About a
quarter of these births are intentional, meaning that the medical team decides to induce labor early or
perform a c-section because of a serious medical condition such as severe or worsening preeclampsia
or because the baby has stopped growing. The rest are known as spontaneous preterm births. You may
end up having a spontaneous preterm birth if prior to 37 weeks you go into labor, your water breaks, or
your cervix dilates with no contractions.
While there are some known risk factors for preterm labor, such as having certain genital tract infections,
placental problems, or cervical insufficiency, in many cases no one knows what causes a woman to go
into labor before term. So it's important for all pregnant women to learn the signs of premature labor and
what to do if it happens to you.
Q1.
What are the signs of preterm labor?
Call your midwife or doctor right away if you're having any of the following symptoms before 37 weeks:
• An increase in vaginal discharge
• A change in the type of discharge — if it becomes watery, mucus-like, or bloody (even if it's pink or just
tinged with blood)
• Any vaginal bleeding or spotting
• Abdominal pain, menstrual-like cramping, or more than four contractions in one hour (even if they don't
hurt)
• An increase in pressure in the pelvic area (a feeling that your baby is pushing down)
• Low back pain, especially if you didn't previously have back pain
These symptoms can be confusing because some of them, such as pelvic pressure or low back pain,
occur during normal pregnancies too, and early contractions may just be harmless Braxton Hicks
contractions. But it's always better to be safe than sorry, so call your midwife or doctor right away if
you're experiencing anything unusual.
Q2.
What should I do if I think I'm going into labor prematurely?
If you have signs of preterm labor or think you're leaking amniotic fluid, call your practitioner, who'll likely
have you go to the hospital for further assessment. Once there, your medical team will monitor your
contractions, watch your baby's heart rate, and test your urine for signs of infection. A doctor or midwife
will do a speculum exam to see whether your membranes have ruptured. She may swab your cervix
and vagina and send one sample to the lab to check for an infection and another for a fetal fibronectin
(fFN) test. This test analyzes your cervical and vaginal fluid for the presence of a protein that helps bind
the amniotic sac to the lining of your uterus. Between 24 and 34 weeks, elevated levels of fFN mean
that this "glue" is disintegrating ahead of schedule (due to contractions or injury to the amniotic sac). A
negative result means that it's highly unlikely that you'll give birth in the next week or two, which can set
your mind at ease and allow your practitioner to hold off on treatments that may prove to be
unnecessary.
Q3.
Will my baby be okay if he's born early?
The closer your baby is to full term at birth, the more likely he is to survive and the less likely he is to
have health problems. Premature babies born between 34 and 37 weeks generally do fine, although
they are still at higher risk for short- and long-term problems compared to babies born full term. On the
other end of the continuum are babies who are extremely premature: These days, some babies born as
early as 24 weeks (or even a bit earlier) may survive thanks to advances in neonatal care, but these
extremely preterm infants require significant medical interventions and long stays in neonatal intensive
care units (NICUs), and the survivors often have serious long-term problems.
The best thing you can do to reduce your risk of preterm birth is to avoid known dangers to your baby like smoking,
drinking, and illicit drug use. Eat a nutritious diet, keep all of your prenatal appointments, and report any symptoms or
problems to your caregiver promptly.
Tackle your home improvement projects. Sit down with your partner and take stock of the things
you'd like to fix around the house before your little one arrives. Then let your partner handle them. (You
shouldn't be exposing yourself to chemicals or getting up on ladders.) Some things for the list:
• Install or check smoke detectors, get a fire extinguisher for each floor of your house, and plan a fire
escape route.
• Fix or remove any broken furniture or fixtures.
• Paint the nursery, hang curtain rods, assemble new furniture.

See the big picture
How your baby's growing

Head to heels, your baby now measures about 13 1/2 inches. Her weight — a pound and a half — isn't
much more than an average rutabaga, but she's beginning to exchange her long, lean look for some
baby fat. As she does, her wrinkled skin will begin to smooth out and she'll start to look more and more
like a newborn. She's also growing more hair — and if you could see it, you'd now be able to discern its
color and texture.
See what's going on in your uterus this week.
How your life's changing

Your baby's not the only one with more hair — your locks may look more full and lustrous than ever. It's
not that you're growing more hair, but thanks to hormonal changes, the hair that you'd normally shed is
sticking around longer than usual. Enjoy the fullness while you can — the extra hair will fall out after you
give birth.
You may also notice that you can't move around as gracefully as before. Unless your caregiver has
advised you otherwise, it's fine to continue to exercise, but follow a few safety rules: Don't work out
when you're feeling overly tired and stop if you feel any pain, dizziness, or shortness of breath. Don't lie
flat on your back and avoid contact sports as well as any exercise where you're apt to lose your
balance. Be sure to drink plenty of water, and make time for both warm-up and cool-down periods.
When you have your glucose-screening test at 24 to 28 weeks, a second tube of blood may be taken at
the same time to check for anemia. If blood tests show that you have iron-deficiency anemia (the most
common type of anemia), your caregiver will probably recommend that you take an iron supplement.
Have you started thinking about baby names yet? Choosing a name is an important decision, but it
should be a fun one, too. You may want to consider family history (Great Grandpa Zeb), favorite
locations (Venice, where you honeymooned), or cherished literary or film characters (Greta, Meg, or
Atticus, for example). Check out a couple of baby-name books to help you brainstorm, too.
Constipation cure: "To ease constipation, add oat or wheat bran to anything you can think of — cereal, yogurt,
smoothies, or even spaghetti sauce." — Kristin
3 Questions About...Third trimester prenatal care
Q1.
How often will I see my caregiver in the third trimester?
Between 28 and 36 weeks, you'll see your caregiver every two weeks. One month before your due date,
this will increase to once a week.
Q2.
What will she do at each appointment?
• Ask how you're feeling physically and emotionally and follow up on any issues raised at your last
appointment. Among other things, she'll want to know if you're having contractions, vaginal bleeding, or
unusual discharge; if you're having headaches; and if you're feeling anxious or depressed. Let her know
if you have any symptoms that haven't been addressed.
• Ask about your baby's movements. She'll remind you to call if you sense that your baby has gotten
less active. At some point, she may ask you to start counting your baby's movements for a set period of
time each day.
• Weigh you and check your urine for signs of preeclampsia, urinary tract infections, and other problems.
Take your blood pressure and check your ankles, hands, and face for swelling.
• Check your baby's heartbeat and do an abdominal exam to estimate your baby's size and position.
She'll measure the distance between your pubic bone and the top of your uterus to see if your baby's
growth rate seems normal.
• Possibly check your cervix. Don't expect a pelvic exam at every visit. Many caregivers don't do one
unless they have a specific concern, such as preterm labor. Once you pass your due date, your provider
will check your cervix to help decide whether (or when) to induce your labor.
• Tell you what to watch out for. She'll tell you about the signs of preterm labor and preeclampsia, and
review other warning signs that should prompt a call. As your due date nears, she'll discuss the signs of
labor and let you know when you should get in touch with her.
• Go over your labor and delivery questions. Make a list with your partner and bring it to a prenatal visit.
• Discuss postpartum decisions like whether you plan to breastfeed or circumcise your son. She'll also
discuss your options for postpartum contraception. If you haven't found a doctor for your baby, your
caregiver can give you some names.
Q3.
What tests are coming up?
Depending on your situation you may be offered:
• Hematocrit/hemoglobin: This blood test for anemia is usually repeated during the third trimester. (If
you were tested when you took your glucose challenge test and the results were normal, it might not be
repeated.)
• Gestational diabetes testing: If you have a normal glucose screening test between 24 and 28 weeks,
consider yourself done. But if your screening results are abnormal and you haven't yet done the glucose
tolerance test, you'll be tested now.
• Rh antibody screening: If you're Rh-negative, the antibody screen will be repeated (usually at the
same time as your glucose challenge test) and you'll get an injection of Rh immune globulin at 28
weeks. In the unlikely case that some of your baby's blood gets into your bloodstream, the Rh immune
globulin will protect you from developing antibodies that could pose a risk to future babies or even this
one. (Note: if your baby's father takes a blood test and is found to be Rh-negative like you, you'll know
that your baby is also Rh-negative so you won't need the Rh immune globulin.)
• Tests for sexually transmitted infections: If you're at high risk, your caregiver will do cervical
cultures to check for chlamydia and gonorrhea, and your blood will be tested for syphilis. It's a wise idea
to be retested for HIV as well if there's any chance you contracted it since your original test because
treatment is available that dramatically reduces the risk of transmitting it to your baby.
• Group B strep test: Between 35 and 37 weeks, you'll be checked for group B streptococci (GBS) in
your vagina and rectum. You won't be treated right away if the cultures are positive, because early
treatment is no guarantee that the bacteria won't return. Instead, you'll be treated with IV antibiotics
when you're in labor. (If you've previously given birth to a baby who had GBS, you can skip this test
because you'll be given antibiotics in labor no matter what.)
• Biophysical profiles and nonstress tests: If you have certain pregnancy complications or you've
passed your due date, these tests will be ordered to check on your baby.

Dedicate time to your partner this week. Treat your partner to a romantic surprise. Write down all the
things you love about him, tell him why you think he'll be a great dad, or just go for a stroll while holding
hands. Take time to connect on a physical and emotional level and celebrate what connects you and
makes you love one another. Try to do something at least once a week that clearly communicates the
importance of your partner in your life, says clinical psychologist Diane Sanford.
See the big picture
How your baby's growing

Head to heels, your baby now measures about 13 1/2 inches. Her weight — a pound and a half — isn't
much more than an average rutabaga, but she's beginning to exchange her long, lean look for some
baby fat. As she does, her wrinkled skin will begin to smooth out and she'll start to look more and more
like a newborn. She's also growing more hair — and if you could see it, you'd now be able to discern its
color and texture.
See what's going on in your uterus this week.
How your life's changing

Your baby's not the only one with more hair — your locks may look more full and lustrous than ever. It's
not that you're growing more hair, but thanks to hormonal changes, the hair that you'd normally shed is
sticking around longer than usual. Enjoy the fullness while you can — the extra hair will fall out after you
give birth.
You may also notice that you can't move around as gracefully as before. Unless your caregiver has
advised you otherwise, it's fine to continue to exercise, but follow a few safety rules: Don't work out
when you're feeling overly tired and stop if you feel any pain, dizziness, or shortness of breath. Don't lie
flat on your back and avoid contact sports as well as any exercise where you're apt to lose your
balance. Be sure to drink plenty of water, and make time for both warm-up and cool-down periods.
When you have your glucose-screening test at 24 to 28 weeks, a second tube of blood may be taken at
the same time to check for anemia. If blood tests show that you have iron-deficiency anemia (the most
common type of anemia), your caregiver will probably recommend that you take an iron supplement.
Have you started thinking about baby names yet? Choosing a name is an important decision, but it
should be a fun one, too. You may want to consider family history (Great Grandpa Zeb), favorite
locations (Venice, where you honeymooned), or cherished literary or film characters (Greta, Meg, or
Atticus, for example). Check out a couple of baby-name books to help you brainstorm, too.
Constipation cure: "To ease constipation, add oat or wheat bran to anything you can think of — cereal, yogurt,
smoothies, or even spaghetti sauce." — Kristin
3 Questions About...Third trimester prenatal care
Q1.
How often will I see my caregiver in the third trimester?
Between 28 and 36 weeks, you'll see your caregiver every two weeks. One month before your due date,
this will increase to once a week.
Q2.
What will she do at each appointment?
• Ask how you're feeling physically and emotionally and follow up on any issues raised at your last
appointment. Among other things, she'll want to know if you're having contractions, vaginal bleeding, or
unusual discharge; if you're having headaches; and if you're feeling anxious or depressed. Let her know
if you have any symptoms that haven't been addressed.
• Ask about your baby's movements. She'll remind you to call if you sense that your baby has gotten
less active. At some point, she may ask you to start counting your baby's movements for a set period of
time each day.
• Weigh you and check your urine for signs of preeclampsia, urinary tract infections, and other problems.
Take your blood pressure and check your ankles, hands, and face for swelling.
• Check your baby's heartbeat and do an abdominal exam to estimate your baby's size and position.
She'll measure the distance between your pubic bone and the top of your uterus to see if your baby's
growth rate seems normal.
• Possibly check your cervix. Don't expect a pelvic exam at every visit. Many caregivers don't do one
unless they have a specific concern, such as preterm labor. Once you pass your due date, your provider
will check your cervix to help decide whether (or when) to induce your labor.
• Tell you what to watch out for. She'll tell you about the signs of preterm labor and preeclampsia, and
review other warning signs that should prompt a call. As your due date nears, she'll discuss the signs of
labor and let you know when you should get in touch with her.
• Go over your labor and delivery questions. Make a list with your partner and bring it to a prenatal visit.
• Discuss postpartum decisions like whether you plan to breastfeed or circumcise your son. She'll also
discuss your options for postpartum contraception. If you haven't found a doctor for your baby, your
caregiver can give you some names.
Q3.
What tests are coming up?
Depending on your situation you may be offered:
• Hematocrit/hemoglobin: This blood test for anemia is usually repeated during the third trimester. (If
you were tested when you took your glucose challenge test and the results were normal, it might not be
repeated.)
• Gestational diabetes testing: If you have a normal glucose screening test between 24 and 28 weeks,
consider yourself done. But if your screening results are abnormal and you haven't yet done the glucose
tolerance test, you'll be tested now.
• Rh antibody screening: If you're Rh-negative, the antibody screen will be repeated (usually at the
same time as your glucose challenge test) and you'll get an injection of Rh immune globulin at 28
weeks. In the unlikely case that some of your baby's blood gets into your bloodstream, the Rh immune
globulin will protect you from developing antibodies that could pose a risk to future babies or even this
one. (Note: if your baby's father takes a blood test and is found to be Rh-negative like you, you'll know
that your baby is also Rh-negative so you won't need the Rh immune globulin.)
• Tests for sexually transmitted infections: If you're at high risk, your caregiver will do cervical
cultures to check for chlamydia and gonorrhea, and your blood will be tested for syphilis. It's a wise idea
to be retested for HIV as well if there's any chance you contracted it since your original test because
treatment is available that dramatically reduces the risk of transmitting it to your baby.
• Group B strep test: Between 35 and 37 weeks, you'll be checked for group B streptococci (GBS) in
your vagina and rectum. You won't be treated right away if the cultures are positive, because early
treatment is no guarantee that the bacteria won't return. Instead, you'll be treated with IV antibiotics
when you're in labor. (If you've previously given birth to a baby who had GBS, you can skip this test
because you'll be given antibiotics in labor no matter what.)
• Biophysical profiles and nonstress tests: If you have certain pregnancy complications or you've
passed your due date, these tests will be ordered to check on your baby.

Dedicate time to your partner this week. Treat your partner to a romantic surprise. Write down all the
things you love about him, tell him why you think he'll be a great dad, or just go for a stroll while holding
hands. Take time to connect on a physical and emotional level and celebrate what connects you and
makes you love one another. Try to do something at least once a week that clearly communicates the
importance of your partner in your life, says clinical psychologist Diane Sanford.
See the big picture

This week, your baby weighs almost 2 pounds (like a head of cauliflower) and is about 14 1/2 inches
long with her legs extended. She's sleeping and waking at regular intervals, opening and closing her
eyes, and perhaps even sucking her fingers. With more brain tissue developing, your baby's brain is
very active now. While her lungs are still immature, they would be capable of functioning — with a lot of
medical help — if she were to be born now. Chalk up any tiny rhythmic movements you may be feeling
to a case of baby hiccups, which may be common from now on. Each episode usually lasts only a few
moments, and they don't bother her, so just relax and enjoy the tickle.

The second trimester is drawing to a close, but as your body gears up for the final lap, you may start
noticing some new symptoms. Along with an aching back, for example, you may find that your leg
muscles cramp up now and then. They're carrying extra weight, after all, and your expanding uterus is
putting pressure on the veins that return blood from your legs to your heart as well as on the nerves
leading from your trunk to your legs. Unfortunately, the cramps may get worse as your pregnancy
progresses. Leg cramps are more common at night but can also happen during the day. When a cramp
strikes, stretching the calf muscle should give you some relief. Straighten your leg and then gently flex
your toes back toward your shin. Walking for a few minutes or massaging your calf sometimes helps,
too.
It may be the furthest thing from your mind right now, but it's not too soon to think about family planning.
You'll want to have made some decisions about postpartum birth control before your baby arrives. If
you're considering a tubal ligation, be aware that most states require you to sign a consent form at least
30 days beforehand. So if you'd like the option of having the surgery during your postpartum hospital
stay, don't wait too much longer to discuss it with your caregiver. (You can still change your mind later.)
Beyond orange juice "Need more vitamin C? Try red bell peppers! They have nearly twice the vitamin C of a navel
orange, and a half cup is one of the five servings of fruits and vegetables you need each day." — Kayla B.
Surprising Facts: Symptoms you should never ignore
So many aches, pains, and strange feelings arise during pregnancy that it can be hard to decide what's
normal and what warrants a call to your doctor or midwife. To complicate matters further, some
symptoms may be more or less urgent depending on your particular situation or health history and on
how far along you are in your pregnancy. Here's a rundown of symptoms that could be a sign of a
problem. If you have any of these complaints, call your doctor or midwife immediately:
Before you reach 37 weeks:
• Pelvic pressure (a feeling that your baby is pushing down), lower back pain (especially if it's a new
problem for you), menstrual-like cramping or abdominal pain, or more than four contractions in an hour
(even if they don't hurt)
• An increase in vaginal discharge or a change in the type of discharge — if it becomes watery, mucus-
like, or bloody (even if it's only pink or blood-tinged)
At any time:
• Your baby is moving or kicking less than usual
• Severe or persistent abdominal pain or tenderness
• Vaginal bleeding or spotting, or watery discharge
• Pain or burning when you urinate, or little or no urination
• Severe or persistent vomiting, or any vomiting accompanied by pain or fever
• Chills or a fever of 100 degrees Fahrenheit or higher
• Blurred or double vision, or seeing spots or "floaters"
• A severe or persistent headache, or any headache accompanied by blurred vision, slurred speech, or
numbness
• Any swelling in your face or puffiness around your eyes, anything more than mild swelling in your
fingers or hands, or severe or sudden swelling in your legs, feet, or ankles, or a rapid weight gain (more
than 4 pounds in a week)
• Severe or persistent leg or calf pain that doesn't ease up when you flex your ankle and point your toes
toward your nose, or one leg significantly more swollen than the other
• Trauma to your abdomen
• Fainting, frequent dizziness, rapid heartbeat, or palpitations
• Difficulty breathing, coughing up blood, or chest pain
• Severe constipation accompanied by abdominal pain or severe diarrhea that lasts more than 24 hours
• Persistent intense itching all over
• Any health problem that you'd ordinarily call your practitioner about, even if it's not pregnancy-related
(like worsening asthma or a cold that gets worse rather than better)
Even if you don't see your symptom on the list above, trust your instincts and call your caregiver whenever you have
a concern about your pregnancy. If there's a problem, you'll get help right away. If nothing's wrong, you'll be
reassured.
Sign up for a breastfeeding class. If you are a first-time mom and planning to breastfeed your baby,
it's a good idea to take a breastfeeding class. Ask your caregiver or childbirth education teacher where
you can take one. Or call La Leche League. It can help you locate breastfeeding resources in your area.

See the big picture

By this week, your baby weighs two and a quarter pounds (like a Chinese cabbage) and measures 14.8
inches from the top of her head to her heels. She can blink her eyes, which now sport lashes. With her
eyesight developing, she may be able to see the light that filters in through your womb. She's also
developing billions of neurons in her brain and adding more body fat in preparation for life in the outside
world.

You're in the home stretch! The third and final trimester starts this week. If you're like most women, you'll
gain about 11 pounds this trimester.
At this point, you'll likely visit your doctor or midwife every two weeks. Then, at 36 weeks, you'll switch to
weekly visits. Depending on your risk factors, your practitioner may recommend repeating blood tests for
HIV and syphilis now, as well as doing cultures for chlamydia and gonorrhea, to be certain of your status
before delivery. Also, if your glucose screening test result was high and you haven't yet had follow-up
testing, you'll soon be given the 3-hour glucose tolerance test. And if the blood work done at your first
prenatal visit showed that you're Rh negative, you'll get an injection of Rh immunoglobulin to prevent
your body from developing antibodies that could attack your baby's blood. (If your baby is Rh positive,
you'll receive another shot of Rh immunoglobulin after you give birth.)
Around this time, some women feel an unpleasant "creepy-crawly" sensation in their lower legs and an
irresistible urge to move them while trying to relax or sleep. If this sensation is at least temporarily
relieved when you move, you may have what's known as restless legs syndrome (RLS). No one knows
for sure what causes RLS, but it's relatively common among expectant mothers. Try stretching or
massaging your legs, and cut down on caffeine, which can make the symptoms worse. Ask your
caregiver if you should try iron supplements, which can sometimes relieve RLS.
Sleep easier "Now that it's later in my pregnancy, I find that if I sleep on either side with a pillow tucked underneath
my stomach, I can make it through the night." –Venece
3 Questions About Preeclampsia
Preeclampsia is a complex disorder that affects 3 to 8 percent of pregnant women. A woman is

diagnosed with preeclampsia if she has high blood pressure and protein in her urine after 20 weeks of
pregnancy. Most women who get preeclampsia develop a mild version near their due date, and they and
their babies do fine with proper care. But when preeclampsia is severe, it can affect many organs and
cause serious or even life-threatening problems. The only way to get better is to deliver the baby.
Q1.
What are the symptoms of preeclampsia?
Preeclampsia can come on suddenly, so it's very important to be aware of the symptoms. Call your
midwife or doctor right away if you notice any of these warning signs:
Swelling in your face or puffiness around your eyes, more than slight swelling of your hands, or
excessive or sudden swelling of your feet or ankles. • Rapid weight gain — more than 4 pounds in a
week.
• Severe or persistent headache
• Vision changes, including double vision, blurred vision, seeing spots or flashing lights, sensitivity to
light, or temporary loss of vision
• Intense pain or tenderness in your upper abdomen
• Nausea and vomiting
Preeclampsia can occur without any obvious symptoms, particularly in the early stages, and some
symptoms may seem like normal pregnancy complaints. So you might not know you have the condition
until it's discovered at a routine prenatal visit. This is one of the reasons it's so important not to miss
your appointments.
Q2.
What puts me at high risk for preeclampsia?
It's more common to get preeclampsia for the first time during a first pregnancy. However, once you've
had preeclampsia, you're more likely to develop it again in later pregnancies. Other risk factors include:
• Having chronic hypertension

• Having certain blood clotting disorders, diabetes, kidney disease, or an autoimmune disease like lupus
• Having a close relative (a mother, sister, grandmother, or aunt, for example) who had preeclampsia
• Being obese (having a body mass index of 30 or more)
• Carrying two or more babies
• Being younger than 20 or older than 40
Q3.
Is there any way I can avoid getting preeclampsia?
No one knows for sure how to prevent preeclampsia, although there's a lot of research going on in this
area. A number of studies have looked into whether taking extra calcium, vitamins, or a low dose of
aspirin can help, but the results have been mixed. For now, the best thing you can do is get good
prenatal care and keep all your prenatal appointments. At each visit your healthcare provider will check
your blood pressure and test your urine for protein. It's also important to be aware of the warning signs
of preeclampsia so that you can alert your caregiver and get treated as soon as possible.
For more information on pregnancy complications, see BabyCenter's comprehensive pregnancy complications area.
Choose a doctor for your baby. Get names of pediatricians or family practitioners from friends, co-
workers, neighbors, or your pregnancy caregiver. Make sure the doctor accepts your health insurance,
keeps hours that work with your schedule, and has an office that's convenient for you. If you can,
schedule face-to-face interviews with your top candidates. If it seems too early to be thinking about this,
consider that your baby will have his first doctor's visit shortly after birth.
See the big picture

Your baby now weighs about 2 1/2 pounds (like a butternut squash) and is a tad over 15 inches long
from head to heel. His muscles and lungs are continuing to mature, and his head is growing bigger to
make room for his developing brain. To meet his increasing nutritional demands, you'll need plenty of
protein, vitamins C, folic acid, and iron. And because his bones are soaking up lots of calcium, be sure
to drink your milk (or find another good source of calcium, such as cheese, yogurt, or enriched orange
juice). This trimester, about 250 milligrams of calcium are deposited in your baby's hardening skeleton
each day.

Your baby's very active now. Your practitioner may ask you to spend some time each day counting kicks
and will give you specific instructions on how to do this. Let her know if you ever notice a decrease in
activity. You may need a nonstress test or biophysical profile to check on your baby's condition.
Some old friends — heartburn and constipation — may take center stage now. The pregnancy hormone
progesterone relaxes smooth muscle tissue throughout your body, including your gastrointestinal tract.
This relaxation, coupled with the crowding in your abdomen, slows digestion, which in turn can cause
gas and heartburn — especially after a big meal — and contribute to constipation as well.
Your growing uterus may also be contributing to hemorrhoids. These swollen blood vessels in your
rectal area are common during pregnancy and usually clear up in the weeks after giving birth. If they're
itchy or painful, try soaking in a sitz bath or applying cold compresses medicated with witch hazel to the
affected area. Also avoid sitting or standing for long stretches. Talk with your practitioner before using
any over-the counter remedies during pregnancy, and let her know if you have any rectal bleeding. To
prevent constipation, eat a high-fiber diet, drink plenty of water, and get some regular exercise.
Some women get something called "supine hypotensive syndrome" during pregnancy, where laying flat
on your back causes a change in heart rate and blood pressure that makes you feel dizzy until you
change position. You might note that you feel lightheaded if you stand up too quickly, too. To avoid "the
spins" lie on your side rather than your back, and move slowly as you go from lying down to sitting and
then standing.
Enjoy your freedom "Shake the pregnancy blahs by enjoying your last weeks of pre-baby freedom. Do all the things
you may not have time for — movies, facials, romantic dinners with your mate — once your little one is here." —
Bethany B.
3 Questions About Maternity leave
Q1.
Does my employer have to let me take maternity leave?
Not necessarily. Many employers are required by the Family and Medical Leave Act (FMLA) to allow
their full-time employees (both men and women) 12 weeks of unpaid family leave after the birth or
adoption of a child. But there are exceptions: Some part-time workers, newer employees, and
employees of companies with fewer than 50 workers aren't covered by the FMLA. But even if you're not
eligible for leave under the FMLA, you may be eligible under your state's provisions. To find out, check
with your state's department of labor.
Actual paid "maternity leave" is unusual in the United States. Some companies offer new parents paid
time off, up to six weeks in some cases. But most likely, you'll use a combination of short-term disability
(STD), sick leave, vacation, personal days, and unpaid family leave to cobble together your maternity
leave.
Q2.
How do I decide when to start my leave?
There's no "right time" to stop working. Some women start their leave in the seventh or eighth month
while others work right up until delivery. You'll need to monitor your pregnancy to determine the right
time to start maternity leave. If your practitioner puts you on bed rest, or complications develop that
require you to be out of work before you give birth, you'll most likely be put on short-term disability if
your state or company offers it.
Once your maternity leave is up, don't be surprised if it's hard to leave your baby and go back to work.
Seventy-eight percent of new moms in a BabyCenter poll said they struggled with the decision to return
to work, while only 22 percent said they were ready to go back.
Q3.
What's the best way to discuss these issues with my boss?
First, do your homework. Review your employee handbook, or contact a human resources
representative who can inform you of your employer's formal policies regarding pregnancy and
maternity leave. You may also want to question your co-workers who have already traveled this path.
Then, make a plan. Figure out how much time you think you'll want to take. If you're considering unpaid
leave, think about how much time without a paycheck you can reasonably afford. Consider whether
you'll want to take maternity leave in one block of time or whether you'd rather split it up over the year.
Under the FMLA, you can use your 12 weeks anyway you want — all at once, a week at a time, some
now, some later, etc. When making these decisions, consider your partner's schedule and benefits too.
Some companies offer paid paternity leave, and your partner may qualify for leave under the FMLA as
well.
To increase your chances of getting what you want, plan to offer your boss solutions rather than
problems by having some ideas for how your work can be handled while you're away.
If you're not sure where to start, read about how seven new moms negotiated their maternity leaves and
transitioned back to work. Seeing how other women made it work can be inspiring.
Find out exactly which questions you should ask your coworkers and human resources department with our maternity
leave checklist, and get the full lowdown on maternity leave.
Run some vital errands now. Here are some things you'll need in the first few weeks when it's almost
impossible to go shopping:
• Diapers and wipes.
• Baby care items such as nail clippers, a thermometer, a bulb syringe, and a pacifier.
• Baby-friendly laundry detergent.
• Sanitary pads for you. (You'll bleed for a few weeks after delivery.)
• Thank-you cards and stamps.
• Paper towels and paper plates for easy cleanup after meals.
See the big picture

Your baby's about 15.7 inches long now, and she weighs almost 3 pounds (like a head of cabbage). A
pint and a half of amniotic fluid surrounds her, but that volume will decrease as she gets bigger and
takes up more room in your uterus. Her eyesight continues to develop, though it's not very keen; even
after she's born, she'll keep her eyes closed for a good part of the day. When she does open them, she'll
respond to changes in light but will have 20/400 vision — which means she can only make out objects a
few inches from her face. (Normal adult vision is 20/20.)


You may be feeling a little tired these days, especially if you're having trouble sleeping. You might also
feel clumsier than normal, which is perfectly understandable. Not only are you heavier, but the
concentration of weight in your pregnant belly causes a shift in your center of gravity. Plus, thanks to
hormonal changes, your ligaments are more lax, so your joints are looser, which may also contribute to
your balance being a bit off. Also, this relaxation of your ligaments can actually cause your feet to
spread permanently, so you may have to invest in some new shoes in a bigger size.
Remember those mood swings you had earlier in pregnancy? The combination of uncomfortable
symptoms and hormonal changes can result in a return of those emotional ups and downs. It's normal to
worry about what your labor will be like or whether you'll be a good parent. But if you can't shake the
blues or feel increasingly irritable or agitated, talk to your doctor or midwife. You may be among the 1 in
10 expectant women who battle depression during pregnancy. Also let your caregiver know if you're
frequently nervous or anxious.
Searching for a pediatrician "I realized that finding a good pediatrician would be at least as important as finding a
good doctor or midwife, so I started my search early. I asked my midwife and her assistant, the workers,
administrators and mothers at two daycare centers, and my local hospital's referral center for recommendations. The
two practitioners whose names came up most often were the ones I interviewed." —Anonymous
Surprising Facts: Common labor fears
Are you nervous about giving birth? You're not alone! Here are some common fears and how to cope
with them.
• I won't be able to handle the pain.

One in five expectant moms says this is her top third-trimester fear, according to a BabyCenter poll.
Some women know ahead of time that they will want pain-relieving medication during labor and, in fact,
most women do end up opting to have an epidural. Others are committed to giving birth without drugs.
They accept potential for pain and discomfort and learn techniques to help them manage it. With the
right preparation and support, some women find natural childbirth deeply satisfying and empowering.
• I'll need an episiotomy or I'll tear.

An episiotomy is a surgical cut in the muscular area between your vagina and anus (the perineum)
which is performed right before delivery to enlarge your vaginal opening. Some women tear
spontaneously in this area during delivery — even with an episiotomy — and the tears can range from
almost undetectable to severe, requiring a significant number of stitches to repair. Once nearly standard,
episiotomies are on the decline and experts now agree that the procedure shouldn't be done routinely.
Talk to your practitioner about how often and under what conditions she performs episiotomies and how
she might help you avoid one, or tearing. There's some evidence that you'll be less likely to need
stitches if you start massaging your perineum about five weeks before your due date.
• I'll have a bowel movement during labor.

In a recent BabyCenter poll, 70 percent of women said they were afraid they'd poop while giving birth,
39 percent said they actually did, and of those, only 22 percent were embarrassed by it. Though it's hard
to believe now, if you do have a bowel movement while you're pushing, no one will blink an eye. Your
caregivers will clean it up possibly even before you know what's happened.
• I'll be steamrolled into unnecessary medical interventions.

The best way to deal with this fear is to have a frank conversation with your practitioner. If you trust and
respect your doctor or midwife, you can rest assured that she'll be doing her best for you and your baby
on the day of delivery. If she's aware of your wishes and preferences (consider writing a birth plan), she
can do her best to adhere to them. Another way to ease this fear is to hire a doula — a professional
labor assistant — to attend your birth. She can be your advocate at the hospital.
• I'll have to have a c-section.

Since one in five women giving birth for the first time ends up having a c-section to deliver her baby, this
fear is understandable. If you have your heart set on a vaginal birth, ending up with a c-section can be
disappointing. Some moms say they feel cheated out of a vaginal birth, especially if they took childbirth
classes and fantasized about the "ideal birth," or if they feel that their c-section wasn't really necessary.
Others say they feel as if they're somehow less of a woman because they needed a c-section. If you
have these feelings, it may take some time to reconcile the reality of your birth experience with what
you'd imagined during your pregnancy. It might help to know that many women find their babies' births,
whether vaginal or c-section, very different from what they expected.
• I won't make it to the hospital on time.

Emergency home deliveries are extremely unusual, especially with first babies. But if you can't shake
this fear, check out our emergency home birth instructions so you'll have an idea of what it involves.
Assemble any baby gear This is the perfect job for your partner or a friend who wants to help. Cribs,
bassinets, and strollers are notoriously tricky to put together, especially when you're sleep deprived, so
get started now. Swings, mobiles, and monitors can all require batteries, so make sure you have enough
on hand. Tip: Consider getting rechargeable batteries and a battery charger
See the big picture

This week, your baby measures over 16 inches long. He weighs about 3.3 pounds (try carrying four
navel oranges) and is heading into a growth spurt. He can turn his head from side to side, and his arms,
legs, and body are beginning to plump out as needed fat accumulates underneath his skin. He's
probably moving a lot, too, so you may have trouble sleeping because your baby's kicks and
somersaults keep you up. Take comfort: All this moving is a sign that your baby is active and healthy.

Have you noticed the muscles in your uterus tightening now and then? Many women feel these random
contractions — called Braxton Hicks contractions — in the second half of pregnancy. Often lasting about
30 seconds, they're irregular, and at this point, they should be infrequent and painless. Frequent
contractions, on the other hand — even those that don't hurt — may be a sign of preterm labor. Call
your practitioner immediately if you have more than four contractions in an hour or any other signs of
preterm labor: an increase in vaginal discharge or a change in the type of discharge (if it becomes
watery, mucus-like, or bloody — even if it's pink or just tinged with blood); abdominal pain or menstrual-
like cramping; an increase in pressure in the pelvic area; or low back pain, especially if you didn't have it
before.
You may have noticed some leaking of colostrum, or "premilk," from your breasts lately. If so, try tucking
some nursing pads into your bra to protect your clothes. (And if not, it's certainly nothing to worry about;
your breasts are making colostrum all the same, even if you don't see any.) If your current bra is too
snug, you might also want to pick up a nursing bra. Choose a nursing bra at least one cup size bigger
than you need now. When your milk comes in you'll be grateful for that extra room!
If you're having a boy, you and your partner will want to take some time to think about whether or not to
have your baby circumcised. Find out the pros and cons from your doctor, and what the procedure
involves.
Choosing a focal point "I'm 31 weeks along, and at my childbirth classes they've been telling us to concentrate on a
focal point during labor. Anything from a picture to a crack in the wall or ceiling can work, so long as it helps Mom
relax and distracts her from the pain." — Anonymous
Decision Guide: Do you want pain medication during labor?
There's no one right way to have a baby. Every woman's experience with pain is different and every
labor is different. Some women know in advance that they want pain medication. Some are committed
to a natural, unmedicated approach to pain management. And some want to try for a drug-free birth with
the option of pain medication if the going gets too rough. Learn all you can about the pros and cons of
the various options so that you can make an informed choice. Here are some things to consider as you
make your decision:
• If you haven't done so already, sign up for a childbirth education class with your partner. Instructors
generally cover all labor pain relief options, including epidurals, spinals, and systemic medication as well
as drug-free approaches like breathing and relaxation techniques.
• Most women opt for some kind of pain medication during childbirth. The most popular form of labor
pain relief, an epidural, delivers continuous pain relief to the lower part of your body while allowing you
to remain fully conscious.
• Some women choose a natural, drug-free approach to controlling labor pain. If you want to remain in
control of your body to the greatest extent possible, be an active participant throughout labor, and have
minimal routine interventions in the birth process, then natural approaches will suit you best. If you
choose to go this route, you accept the potential for pain and discomfort as part of giving birth, but with
the right preparation and support, you may find it works well for you.
• Whether you've decided to use pain medication during labor or are committed to natural childbirth,
remember that you have the right to change your mind once you're in labor.
• Take our poll: Have you decided to use drugs during childbirth?
You don't need to pack your bag yet, but start making a list of items to bring to the hospital.
Besides a change of clothes and a toothbrush, some items to include:
• A photograph or object to focus on during labor
• Snacks to keep your energy up and gum or mints for bad breath
• Cozy socks and slippers
• Your favorite pillow
• Some light reading material
• A nursing nightie and nursing bra
• A going-home outfit for your baby
• A camera or camcorder, fresh batteries, and film, if necessary
See the big picture

By now, your baby weighs 3.75 pounds (pick up a large jicama) and is about 16.7 inches long, taking up
a lot of space in your uterus. You're gaining about a pound a week and roughly half of that goes right to
your baby. In fact, she'll gain a third to half of her birth weight during the next 7 weeks as she fattens up
for survival outside the womb. She now has toenails, fingernails, and real hair (or at least respectable
peach fuzz). Her skin is becoming soft and smooth as she plumps up in preparation for birth.

To accommodate you and your baby's growing needs, your blood volume has increased 40 to 50
percent since you got pregnant. With your uterus pushing up near your diaphragm and crowding your
stomach, the consequences may be shortness of breath and heartburn. To help relieve your discomfort,
try sleeping propped up with pillows and eating smaller meals more often.
You may have lower-back pain as your pregnancy advances. If you do, let your caregiver know right
away, particularly if you haven't had back pain before, since it can be a sign of preterm labor.
Assuming it's not preterm labor that's ailing you, you can probably blame your growing uterus and
hormonal changes for your aching back. Your expanding uterus shifts your center of gravity and
stretches out and weakens your abdominal muscles, changing your posture and putting a strain on your
back. Hormonal changes in pregnancy loosen your joints and the ligaments that attach your pelvic
bones to your spine. This can make you feel less stable and cause pain when you walk, stand, sit for
long periods, roll over in bed, get out of a low chair or the tub, bend, or lift things.
Get support from your partner "Sleeping is getting difficult. The only way I can get any rest is to lie with my back to
my husband as he cradles my body. The support from him and a pillow between my legs is the best help." —
Anonymous
Decision Guide: Who should be in the labor room with you?
Childbirth is an intensely personal experience, as is your decision whether to have additional family
members, friends, or labor coaches in the birthing room with you. Here are some things to keep in mind
as you prepare your guest list:
• There's no one right decision. In a recent BabyCenter poll, 44 percent of expectant moms said they
preferred to have no one but their partner and medical staff in the room when they gave birth, while 37
percent said they brought an additional relative along and 16 percent requested to have a friend
present. Only 3 percent of respondents asked for a doula or labor coach in the birthing room.
• Some husbands or partners may be confused about their role in the birth or reluctant to participate if
others are present. If you bring outside relatives or coaches in, make sure your partner is on board with
the plan.
• You may be under pressure from mothers or mothers-in-law who are eager to be present for the birth
of their grandchild — regardless of your wishes to keep the experience private. If you want to be alone
with your partner, don't be afraid to enlist hospital staff for support in carrying out your wishes and
keeping relatives out of the delivery room.
• Labor and delivery nurses come and go according to their shifts, so if you'd like to be attended
continuously by one person, a private labor coach or doula is a good option. In fact, some research
shows that women attended by labor assistants have shorter labors, fewer labor complications, and
healthier newborns. You should also give serious thought to having a doula present if you're set on
having a drug-free birth.
• Take our poll: Will you use a doula?
Start lining up helpers. Your friends and family will want to pitch in after your baby's born, but many
new moms are too overwhelmed to direct household help. How to prepare now:
• If anyone offers to help during the newborn weeks, write down their name and number.
• Select one friend to set up a schedule so that all the friends who wish to help are given a date on
which they can bring you a meal.
• Create a master grocery list so you can hand it off to a friend.
• Create a childcare or ride schedule for older children.
• Line up a friend or neighbor to take out your garbage, walk your dog or feed your pets.
See the big picture

This week your baby weighs a little over 4 pounds (heft a pineapple) and has passed the 17-inch mark.
He's rapidly losing that wrinkled, alien look and his skeleton is hardening. The bones in his skull aren't
fused together, which allows them to move and slightly overlap, thus making it easier for him to fit
through the birth canal. (The pressure on the head during birth is so intense that many babies are born
with a conehead-like appearance.) These bones don't entirely fuse until early adulthood, so they can
grow as his brain and other tissue expands during infancy and childhood.

As your baby fills out even more of your belly, lots of things might start to change: Whereas before you
were sashaying, you may find yourself waddling. Finding an easy position to sit in — let alone sleep —
is becoming more of a challenge. And bumping into chairs and counters is par for the course.
You may be feeling some achiness and even numbness in your fingers, wrists, and hands. Like many
other tissues in your body, those in your wrist can retain fluid, which can increase pressure in the carpal
tunnel, a bony canal in your wrist. Nerves that run through this "tunnel" may end up pinched, creating
numbness; tingling, shooting or burning pain; or a dull ache. Try wearing a splint to stabilize your wrist or
propping your arm up with a pillow when you sleep. If your work requires repetitive hand movements (at
a keyboard or on an assembly line, for instance), remember to stretch your hands when you take breaks
— which should be frequently.
Many women are still feeling sexy at this stage — and their partners often agree. You may need to make
some adjustments, but for most women, sex during pregnancy is fine right up until their water breaks or
their labor starts.
Bored with pregnancy? Try this! "Every time I start to get bored with my pregnancy, I lie down and rub my belly.
Sure enough, my baby starts to kick, and I think about how wonderful it will be when I'm able to hold him." — Barbara
3 Questions About... Monitoring your baby's movements
Q1.
How often should I feel movements?
Your baby should be moving as frequently as she has for the last month or so. Every baby has her own
pattern of activity and there's no correct one. As long as you don't notice any major changes in your
baby's activity level, chances are she's doing just fine.
Q2.
Do I need to keep track of my baby's kicks?
For an added sense of security, many practitioners recommend that after 28 weeks, you formally
monitor your baby's movements at least once or twice a day. There are lots of different ways to do these
"kick counts," so check with your caregiver about how she wants you to track your baby's movements.
Here's one common approach: Choose a time of day when your baby tends to be active. (Ideally, you'll
want to do the counts at roughly the same time each day.) Sit quietly or lie on your side so you won't get
distracted. Time how long it takes for you to feel ten distinct movements — kicks, twitches, and whole
body movements all count. You should feel at least ten movements within two hours. (Don't worry; it
probably won't take that long. Sometimes you'll feel ten kicks within the first ten minutes.) If you don't
feel ten movements in two hours, stop counting and call your midwife or doctor.
Q3.
What should I do if I think my baby's movements have slowed down or changed?
Let your practitioner know right away if you notice a slowdown of your baby's movements. A decrease in
fetal movement may signal a problem, and you'll need a nonstress test or biophysical profile to check on
your baby.
Wash your baby's clothing and bedding. You know all those adorable outfits you bought or received
at your baby shower? You should wash anything that will go near your baby's skin to remove any
irritants in the fabrics. The gentlest detergents are those designed for babies and those that are labeled
hypoallergenic or good for sensitive skin.
See the big picture

Your baby now weighs about 4 3/4 pounds (like your average cantaloupe) and is almost 18 inches long.
Her fat layers — which will help regulate her body temperature once she's born — are filling her out,
making her rounder. Her skin is also smoother than ever. Her central nervous system is maturing and
her lungs are continuing to mature as well. If you've been nervous about preterm labor, you'll be happy
to know that babies born between 34 and 37 weeks who have no other health problems generally do
fine. They may need a short stay in the neonatal nursery and may have a few short-term health issues,
but in the long run, they usually do as well as full-term babies.

By this week, fatigue has probably set in again, though maybe not with the same coma-like intensity of
your first trimester. Your tiredness is perfectly understandable, given the physical strain you're under and
the restless nights of frequent pee breaks and tossing and turning, while trying to get comfortable. Now's
the time to slow down and save up your energy for labor day (and beyond). If you've been sitting or lying
down for a long time, don't jump up too quickly. Blood can pool in your feet and legs, causing a
temporary drop in your blood pressure when you get up that can make you feel dizzy.
If you notice itchy red bumps or welts on your belly and possibly your thighs and buttocks as well, you
may have a condition called pruritic urticarial papules and plaques of pregnancy (PUPPP for short). Up
to one percent of pregnant women develop PUPPP, which is harmless but can be quite uncomfortable.
See your practitioner so she can make sure it's not a more serious problem, provide treatment to make
you more comfortable, and refer you to a dermatologist if necessary. Also be sure to call her if you feel
intense itchiness all over your body, even if you don't have a rash. It could signal a liver problem.
Slide your way to slumber "In the third trimester, turning over in bed is a nightmare. The solution? Big satin
pajamas and even satin sheets — the slipperiness of satin helps tremendously!" — Carrie
3 Questions About...C-sections
Q1.
What are my chances of having a c-section?
About 30 percent of pregnant women in the United States give birth by cesarean section these days. In
certain cases the surgery is scheduled in advance. In others, it's done in response to an unforeseen
complication.
Q2.
W hy might I need a c-section?
You may have an unplanned cesarean delivery for many reasons, such as if your cervix stops dilating,
your baby stops progressing down the birth canal, or your baby's heart-rate gives your practitioner
cause for concern. A planned cesarean may be recommended if:
• You've had a previous cesarean with a "classical" vertical uterine incision or more than one previous c-
section. (If you've had only one previous c-section with a horizontal incision, you may be a good
candidate for a vaginal birth after cesarean, or VBAC.)
• You've had some other kind of invasive uterine surgery, such as a myomectomy (the surgical removal
of fibroids).
• You're carrying more than one baby. (Some twins can be delivered vaginally, but all higher-order
multiples require a c-section.)
• Your baby is expected to be very large (a condition known as macrosomia).
• Your baby is in a breech (bottom first) or transverse (sideways) position. (In some cases, such as a
twin pregnancy in which the first baby is head down but the second baby is breech, the breech baby
may be delivered vaginally.)
• You have placenta previa (when the placenta is so low in the uterus that it covers the cervix).
• The baby has a known illness or abnormality that would make a vaginal birth risky.
• You're HIV-positive, and blood tests done near the end of pregnancy show that you have a high viral
load.
Q3.
What should I expect during a c-section?
Typically, your partner can be with you during the surgery. If you don't already have one, your medical
team will start an IV and insert a catheter to drain urine during the procedure, and you'll be given an
epidural or spinal block, which will numb the lower half of your body but leave you alert and awake. A
screen will be put up so you don't have to watch the actual procedure. Once the doctor reaches the
uterus and makes the final incision, she'll ease the baby out, lifting him so you get a glimpse of him
before he's handed off to be cared for by a pediatrician or nurse. While the staff is examining your baby,
the doctor will deliver your placenta and stitch you back up. When your baby has been examined, the
pediatrician or nurse may hand him to your partner, who can hold him right next to you so you can
nuzzle and kiss him while you're being stitched up. Closing your uterus and belly takes a lot longer, than
opening you up. This part of the surgery usually takes about 30 minutes. When the surgery is
completed, you'll be wheeled into a recovery room, where you'll be able to hold your baby and
breastfeed if you want to.
Make a labor contingency plan. You may go into labor early or have a complication that requires you
to be in the hospital longer than you anticipated. Give at least one friend or neighbor the keys to your
house in case you need something and can't get home. Line up people to do the following on a
moment's notice:
• Take care of children
• Drive older children to and from school and to any afterschool activities
• Feed the dog, water the plants, get the mail
• Fill in for you at work or any other obligations
See the big picture

Your baby doesn't have much room to maneuver now that he's over 18 inches long and tips the scales
at 5 1/4 pounds (pick up a honeydew melon). Because it's so snug in your womb, he isn't likely to be
doing somersaults anymore, but the number of times he kicks should remain about the same. His
kidneys are fully developed now, and his liver can process some waste products. Most of his basic
physical development is now complete — he'll spend the next few weeks putting on weight.
Your uterus — which was entirely tucked away inside your pelvis when you conceived — now reaches
up under your rib cage. If you could peek inside your womb, you'd see that there's more baby than
amniotic fluid in there now. Your ballooning uterus is crowding your other internal organs, too, which is
why you probably have to urinate more often and may be dealing with heartburn and other
gastrointestinal distress. If you're not grappling with these annoyances, you're one of the lucky few.
From here on out, you'll start seeing your practitioner every week. Sometime between now and 37
weeks, she'll do a vaginal and rectal culture to check for bacteria called Group B streptococci (GBS).
(Don't worry — the swab is the size of a regular cotton swab, and it won't hurt at all.) GBS is usually
harmless in adults, but if you have it and pass it on to your baby during birth, it can cause serious
complications, such as pneumonia, meningitis, or a blood infection. Because 10 to 30 percent of
pregnant women have the bacteria and don't know it, it's vital to be screened. (The bacteria come and
go on their own — that's why you weren't screened earlier in pregnancy.) If you're a GBS carrier, you'll
get IV antibiotics during labor, which will greatly reduce your baby's risk of infection.
This is also a good time to create a birth plan. Using our form will help you focus on specifics — like
who'll be present, what pain management techniques you want to try, and where you want your baby to
stay after you deliver. It will give you a starting point to discuss your preferences with your medical team.
Childbirth is unpredictable, and chances are you won't follow your plan to the letter, but thinking about
your choices ahead of time — and sharing your preferences with your caregiver — should take some of
the anxiety out of the process.
Prep early for those first weeks "To streamline a chore like filling out birth announcements, address and stamp
your envelopes now while you're still in control of your time." — Laura
3 Questions About...Arriving at the hospital
Q1.
How can I prepare for my arrival at the hospital?
Long before you go into labor, you and your partner should map out the most direct route to the hospital
or birth center. Find out where to park, keeping in mind that you'll be leaving your car for at least 24
hours. Ask the hospital staff where you should enter if you arrive after-hours. Most hospitals offer tours
of the obstetrical floor at designated times. Taking advantage of these tours will give you a chance to do
a dry run before the big day.
Q2.
What should I do when I get to the hospital?
If you've preregistered, you should follow the instructions you've been given, which probably include
breezing right by the front desk and going directly to the maternity ward. If you haven't preregistered,
you can probably still head directly to the maternity ward. There's usually a check-in desk once you get
there. The staff there will help you deal with any necessary paperwork.
A nurse may lead you directly to a birthing room and pair you with a labor and delivery nurse. If it's not
clear that you're in active labor or need to be admitted for other reasons, she'll most likely bring you to
an exam room first. Your caregiver will evaluate you there to see if you're ready to be admitted.
The nurse will ask you for a urine sample and have you change your clothes. Then she'll check your
vital signs and ask when your contractions started and how far apart they are, whether your water's
broken, and whether you've had any vaginal bleeding. She'll also want to know if your baby's been
moving, if you've recently had anything to eat or drink, and how you're coping with the pain.
Your caregiver will check the frequency and duration of your contractions as well as your baby's heart
rate. Then she'll perform an abdominal and vaginal exam. If it looks like you're not in labor or are still in
early labor— and everything is okay with you and your baby — you'll probably be sent home until your
labor is further along. Otherwise, you'll be admitted.
Q3.
What will happen once I'm admitted?
The nurse or your caregiver may ask if you have a birth plan. Even if you don't have a written plan,
share your needs and preferences with the staff, including your feelings about using pain medication
during labor.
Then you'll have blood drawn (to find out your blood type among other things) and an IV may be started.
You'll definitely need an IV to get antibiotics if you test positive for Group B strep, for hydration if you
can't keep fluids down, if you want a spinal or an epidural, if you need oxytocin (Pitocin), or if you have
any health problems or pregnancy complications.
Your nurse or caregiver should also orient you, showing you where everything is in your room and
where your partner can get ice for you. Don't be shy about requesting things you might need, like a
rocking chair, a cool washcloth, or another blanket, or asking any lingering questions you might have.
And if you're going to have continuous electronic fetal monitoring and are interested in how it works, ask
her to explain which lines on the strip show your contractions and which show the heartbeat, and let her
know if you'd prefer the volume on the machine to be turned up or down.
Talk to your caregiver about preregistering at the hospital. If you prepare the paperwork now, you won't have to worry
about it on the big day.
• Did you let nature take its course or did you try to plan your baby's birth for a particular day, month, or
season?
Prepare food to eat after your baby's born. If you cook, start doubling recipes and freezing half. You
and your partner will be too exhausted to cook in the first weeks after you bring your baby home and
you'll be thrilled to have healthy meals you can heat up fast. If you don't cook, go around your
neighborhood and pick up all the takeout and delivery menus you can find. You'll be grateful for all the
options at your fingertips.
See the big picture

Your baby is still packing on the pounds — at the rate of about an ounce a day. She now weighs almost
6 pounds (like a crenshaw melon) and is more than 18 1/2 inches long. She's shedding most of the
downy covering of hair that covered her body as well as the vernix caseosa, the waxy substance that
covered and protected her skin during her nine-month amniotic bath. Your baby swallows both of these
substances, along with other secretions, resulting in a blackish mixture, called meconium, will form the
contents of her first bowel movement.
At the end of this week, your baby will be considered full-term. (Full-term is 37 to 42 weeks; babies born
before 37 weeks are pre-term and those born after 42 are post-term.) Most likely she's in a head-down
position. But if she isn't, your practitioner may suggest scheduling an "external cephalic version," which
is a fancy way of saying she'll try to coax your baby into a head-down position by manipulating her from
the outside of your belly.

Now that your baby is taking up so much room, you may have trouble eating a normal-size meal.
Smaller, more frequent meals are often easier to handle at this point. On the other hand, you may have
less heartburn and have an easier time breathing when your baby starts to "drop" down into your pelvis.
This process — called lightening — often happens a few weeks before labor if this is your first baby. (If
you've given birth before, it probably won't happen before labor starts.) If your baby drops, you may also
feel increased pressure in your lower abdomen, which may make walking increasingly uncomfortable,
and you'll probably find that you have to pee even more frequently. If your baby is very low, you may feel
lots of vaginal pressure and discomfort as well. Some women say it feels as though they're carrying a
bowling ball between their legs!
You might also notice that your Braxton Hicks contractions are more frequent now. Be sure to review the
signs of labor with your practitioner and find out when she wants to hear from you. As a general rule, if
you're full-term, your pregnancy is uncomplicated, and your water hasn't broken, she'll probably have
you wait to come in until you've been having contractions that last for about a minute each, coming
every five minutes for an hour. Of course, you'll want to call right away if you notice a decrease in your
baby's activity or think you're leaking amniotic fluid, or if you have any vaginal bleeding, fever, a severe
or persistent headache, constant abdominal pain, or vision changes.
Even if you're enjoying an uncomplicated pregnancy, it's best to avoid flying (or any travel far from
home) during your final month because you can go into labor at any time. In fact, some airlines won't let
women on board who are due to deliver within 30 days of the flight.
Eating in "Start collecting take-out and delivery menus from local restaurants. You won't have time to cook in the
early weeks after giving birth. Even restaurants without a visible take-out business will usually accommodate a to-go
order (especially if it's for a new mom!)." — Kristina
Surprising Facts: The stages of labor
For first-time moms, labor takes an average of 15 hours, though it's not uncommon to last more than 20.
(For women who've previously had a vaginal birth, it takes eight hours, on average.) The process of
labor and birth is divided into three main stages. Here are the highlights on how childbirth progresses:
First stage The first stage begins when you start having contractions that progressively dilate and
efface your cervix and it ends when your cervix is fully dilated. This stage is divided into two phases,
early and active labor.
It can be tricky to determine exactly when early labor starts. That's because early labor contractions are
sometimes hard to distinguish from the inefficient Braxton Hicks contractions that you may have been
feeling for some time.
Unless there are complications or your midwife or doctor has advised you otherwise, expect to sit out
most of your early labor at home. (Be sure, though, to check in with your caregiver to make certain.)
Early labor ends when your cervix is about 4 centimeters dilated and your progress starts to speed up.
At this point, you enter what's known as the active phase of labor. Your contractions become more
frequent, longer, and stronger.
The last part of the active phase — when your cervix dilates from 8 to 10 centimeters — is called the
transition period because it marks the transition to the second stage of labor. This is the most intense
part of the first stage, with contractions that are usually very strong, coming about every two and a half
to three minutes and lasting a minute or more.
Second stage Once your cervix is fully dilated, the second stage of labor begins: the final descent and
birth of your baby. This is the "pushing" stage of labor, and it can last anywhere from minutes to a few
hours. (It's likely to be quicker if you've previously given birth vaginally.)
Your baby's head will continue to advance with each push until it "crowns" — the term used to describe
the time when the widest part of your baby's head is finally visible. After your baby's head comes out,
your midwife or doctor will suction his mouth and nose, and feel around his neck for the umbilical cord.
His head then turns to the side as his shoulders rotate inside the pelvis to get into position for their exit.
With the next contraction, you'll be coached to push as his shoulders deliver, one at a time, followed by
the rest of his body.
You may feel a wide range of emotions now: euphoria, awe, pride, disbelief, excitement (to name a few),
and, of course, intense relief that it's all over. Exhausted as you may be, you'll also probably feel a burst
of energy, and any thoughts of sleep will vanish for the time being.
Stage three The final stage of labor begins immediately after the birth of your baby and ends with the
delivery of your placenta. The contractions in the third stage are relatively mild.
Get a more detailed account of what happens during each stage of labor.
Create a grapevine. Make a list of all the people you want to hear about your baby's birth — with their
phone numbers or e-mail addresses — and pass this along to a friend who can spread the news. That
way, when you're ready for others to know, all you have to do is make one call. Include at least one
person from work on the list, so they can spread the word there.
See the big picture

Congratulations — your baby is full term! This means that if your baby arrives now, his lungs should be
fully mature and ready to adjust to life outside the womb, even though your due date is still three weeks
away.
Your baby weighs 6 1/3 pounds and measures a bit over 19 inches, head to heel (like a stalk of Swiss
chard). Many babies have a full head of hair at birth, with locks from 1/2 inch to 1 1/2 inches long. But
don't be surprised if your baby's hair isn't the same color as yours. Dark-haired couples are sometimes
thrown for a loop when their children come out as blonds or redheads, and fair-haired couples have
been surprised by Elvis look-alikes. And then, of course, some babies sport only peach fuzz.

Braxton Hicks contractions may be coming more frequently now and may last longer and be more
uncomfortable. You might also notice an increase in vaginal discharge. If you see some "bloody show"
(mucus tinged with a tiny amount of blood) in the toilet or in your undies, labor is probably a few days
away — or less. (If you have heavier spotting or bleeding, call your caregiver immediately.) Also be sure
to ask your caregiver about the results of your Group B strep culture. That way, if the result isn't yet on
your chart when you get to the hospital or birth center, you'll be able to give the staff there a timely
heads-up if you need antibiotics.
It may be harder than ever to get comfortable enough to sleep well at night. If you can, take it easy
through the day — this may be your last chance to do so for quite a while. Keep monitoring your baby's
movements, too, and let your caregiver know immediately if you notice a decrease. Though her quarters
are getting cozy, she should still be as active as before.
While you're sleeping, you're likely to have some intense dreams. Anxiety both about labor and about
becoming a parent can fuel a lot of strange flights of unconscious fancy.
Home alone "I know some people are thrilled to show off their new baby. But all I wanted to do was curl up with her
in my arms when I got home from the hospital. Next time I'll tell people ahead of time that we aren't seeing visitors for
the first week." — Anonymous
Surprising Facts: Signs of labor

There's no way to predict when labor is going to start. Your body actually starts "preparing" for labor up
to a month before you give birth. You may be blissfully unaware of what's going on or you may begin to
notice new symptoms as your due date draws near.
Here are some things that may happen in the weeks or days before labor starts:
• Your baby drops. If this is your first pregnancy, you may feel what's known as "lightening" a few weeks
before labor starts as your baby descends lower into your pelvis. You might detect a heaviness in your
pelvis as this happens and notice less pressure just below your ribcage, making it easier to catch your
breath.
• You note an uptick in Braxton Hicks contractions. More frequent and intense Braxton Hicks
contractions can signal pre-labor, during which your cervix ripens and the stage is set for true labor.
Some women experience a crampy, menstrual-like feeling during this time.
• You pass your mucus plug. The mucus plug is the small amount of thickened mucus that blocks the
cervical canal leading to your uterus. The plug may come out all at once in a lump, or as increased
vaginal discharge over the course of several days. The mucus may be tinged with blood (which may be
brown, pink, or red), in which case it may be referred to as "bloody show."
• Your water breaks. Most women start having regular contractions sometime before their water breaks,
but in some cases, the water breaks first. When this happens, labor usually follows soon. (If contractions
don't start promptly on their own, you'll be induced.) Whether the amniotic fluid comes out in a large
gush or a small trickle, call your doctor or midwife.
How can I tell if I'm in false labor or true labor?

Sometimes it's very hard to tell false labor from the early stages of true labor. Here are some things that
might help you sort it out:
• False labor contractions are unpredictable. They come at irregular intervals and vary in length and
intensity. Although true labor contractions may be irregular at first, over time they start coming at regular
and shorter intervals, become increasingly more intense, and last longer.
• With false labor, the pain from the contractions is more likely to be centered in your lower abdomen.
With true labor, you may feel the pain start in your lower back and wrap around to your abdomen.
• False labor contractions may subside on their own, or when you start or stop an activity or change
position. True labor contractions will persist and progress regardless of what you do.
Figure out how to install your baby's car seat. You can't bring your baby home without a car seat and
it's harder to install than you think, so don't wait until the last minute. Some car seat manufacturers have
a toll-free number for you to call so an expert can walk you through the process. Or get a car seat safety
inspector to help you. To find one in your area, go to the National Highway Traffic Safety Administration's
Web site or look in your local phone book.
See the big picture

Your baby has really plumped up. She weighs about 6.8 pounds and she's over 19 1/2 inches long (like
a leek). She has a firm grasp, which you'll soon be able to test when you hold her hand for the first time!
Her organs have matured and are ready for life outside the womb.
Wondering what color your baby's eyes will be? You may not be able to tell right away. If she's born with
brown eyes, they'll likely stay brown. If she's born with steel gray or dark blue eyes, they may stay gray
or blue or turn green, hazel, or brown by the time she's 9 months old. That's because a child's irises (the
colored part of the eye) may gain more pigment in the months after she's born, but they usually won't
get "lighter" or more blue. (Green, hazel, and brown eyes have more pigment than gray or blue eyes.)

For many women, the next couple of weeks are a waiting game. Use this time to prepare your baby's
nursery or to take care of necessary tasks you may not get around to for a while after your baby's born.
Take naps, catch up on your reading, and spend uninterrupted time with your partner while you can.
Some swelling in your feet and ankles is normal during these last weeks, but call your practitioner
without delay if you notice excessive or sudden swelling of your feet or ankles, more than slight swelling
of your hands, any swelling in your face or puffiness around your eyes, or have a sudden weight gain.
Also let her know immediately if have severe or persistent headaches; visual changes (such as double
or blurred vision, seeing spots or flashing lights, light sensitivity, or a temporary loss of vision), intense
upper abdominal pain or tenderness, or nausea and vomiting. These are symptoms of a serious
condition called preeclampsia.
3 Questions About... Preparing to breastfeed
Q1.
Why is breastfeeding considered the best way to feed a baby?
Breast milk is nature's most perfect food for babies. It has just the right proportion and types of proteins,
carbs, and fats, along with almost all of the vitamins and minerals that a baby needs in the first six
months of life. Dozens of studies have confirmed the benefits of breastfeeding and new ones are
published all the time. Here's a look at some of the highlights. Breastfeeding can:
• help protect your baby from diarrhea, respiratory problems, and ear infections.
• reduce your baby's risk for allergies, leukemia, and possibly obesity.
• reduce your stress level and risk of breast cancer.
Q2.
What can I do to prepare for breastfeeding?
You can set yourself up for breastfeeding success by reading about how to breastfeed and learning
where to turn for help if the going gets rough. Here are four key things to know:
• Insist that you and your baby have skin-to-skin contact immediately after birth (unless either of you has
a medical complication) so you can start breastfeeding as soon as possible. If you have a c-section, ask
that your baby join you in the recovery room as soon as your surgery is done.
• Realize that nursing doesn't come naturally to every woman, and if you're feeling discouraged, you're
not alone. Get help early while you're still at the hospital or birth center to make sure you and your baby
get the hang of breastfeeding before you go home.
• Nurse your newborn frequently — eight to 12 times every 24 hours. And unless medically necessary,
your baby shouldn't get anything but breast milk until breastfeeding is well established (for the first few
weeks at least).
• For more information, see BabyCenter's comprehensive breastfeeding area.
Q3.
Does breastfeeding hurt?
Just because breastfeeding is the most natural way to nourish your baby doesn't mean it's always easy.
For many women, breastfeeding can be uncomfortable or even painful at first. Don't suffer in silence.
Pain is often an indication that your baby isn't attached to your breast properly. Her mouth should cover
a large part of your areola (the pigmented skin around your nipple). Your nipple should be far back in
your baby's mouth. If nursing hurts after your baby's first few sucks, break the suction by inserting your
little finger between your baby's gums and your nipple — and try again until you find a position that's
less painful. Talk to a lactation consultant before you leave the hospital to make sure your baby is
latching on to your breast correctly. If your hospital doesn't provide lactation support or you encounter
difficulties after leaving the hospital, you can contact La Leche League International for help.
Some women are totally comfortable breastfeeding in public, while others feel self-conscious. If you're
worried about it, carry a jacket or extra blanket with you when you go out with your baby. That way, if he
needs to nurse before while you're out, you can drape it over your shoulder and your baby's head for
privacy.
Start reading up on baby care. If you haven't already, now is the perfect time to switch reading gears
from pregnancy to baby. You won't have as much time to read after your baby's born, so learn all you
can about the first few weeks now. A good place to start is BabyCenter's Preparing for a Newborn area.
See the big picture

Your baby's waiting to greet the world! He continues to build a layer of fat to help control his body
temperature after birth, but it's likely he already measures about 20 inches and weighs a bit over 7
pounds, a mini watermelon. (Boys tend to be slightly heavier than girls.) The outer layers of his skin are
sloughing off as new skin forms underneath.

At each of your now-weekly visits, your caregiver will do an abdominal exam to check your baby's
growth and position. She might also do an internal exam to see whether your cervix has started
ripening: softening, effacing (thinning out), and dilating (opening). But even armed with this information,
there's still no way for your caregiver to predict exactly when your baby is coming. If you go past your
due date, your caregiver will schedule you for fetal testing (usually a sonogram) after 40 weeks to
ensure that it's safe to continue the pregnancy. If you don't go into labor on your own, most practitioners
will induce labor when you're between one and two weeks overdue — or sooner if there's an indication
that the risk of waiting is greater than the risks of delivering your baby without further delay.
While you're waiting, it's important to continue to pay attention to your baby's movements and let your
caregiver know right away if they seem to decrease. Your baby should remain active right up to delivery,
and a noticeable slowdown in activity could be a sign of a problem. Also call if you think your water may
have broken. Membranes rupture before the beginning of labor in about 8 percent of term pregnancies.
Sometimes there's a big gush of fluid, but sometimes there's only a small gush or a slow leak. (Don't try
to make the diagnosis yourself. Call even if you only suspect you have a leak.) If you rupture your
membranes and don't start contractions on your own, you'll be induced.
Surprising Facts: How your body changes after giving birth
Even if your labor and delivery was fast and easy, it will take some time for you to feel like your old self
again. It may be hard, but try to remember that it took nine months to get here, so you won't bounce
back — emotionally or physically — overnight.
What to expect from your body:
• You'll start losing weight right away. While you probably won't return to your pre-pregnancy weight for
some time, most women are about 12 pounds lighter after delivering one 7- to 9-pound baby and losing
another pound or two of placenta and another two pounds or so of blood and amniotic fluid. Although it
will take a while for your body to regain its pre-pregnancy shape — that pregnant belly may stick around
for longer than you'd like — by the end of the first week, you'll probably have lost about 4 pounds of
water weight.
• You'll have lochia discharge. After your baby is born, the cells that form the lining of your uterus will
begin to slough off. This results in a discharge called lochia that lasts for weeks. At first, this discharge is
mixed with blood, so it appears bright red and menstrual-like, then it gradually gets lighter in color, finally
fading to white or yellow before it stops.
• Your emotions will be in flux. Within the first week or two of giving birth, many new moms experience
the "baby blues." You may find yourself moody and weepy, exhausted, unable to sleep, or feeling
trapped or anxious. Your appetite can change, too — you might want to eat more or less. The good
news is this emotional upheaval will generally pass within two to three weeks.
Call your caregiver if: • You have signs of abnormal vaginal bleeding, such as soaking more than one
sanitary pad in an hour, passing blood clots bigger than a golf ball, or bright red bleeding that occurs
four days or more after you give birth. You may have what's called a delayed postpartum hemorrhage.
(Note: Call 911 if you're bleeding profusely or if you have any signs of shock, including lightheadedness,
weakness, rapid heartbeat or palpitations, rapid or shallow breathing, clammy skin, restlessness, or
confusion.)
• You have signs of infection, which may include any fever; lower abdominal pain or foul-smelling
discharge (signs of endometritis); difficulty urinating, painful urination, cloudy or bloody urine (signs of a
urinary tract infection); redness, tenderness, discharge, or swelling around the site of a wound (such as
a c-section incision, episiotomy, or laceration); a painful, hard, reddened area, usually only on one
breast, and fever, chills, muscle aches or fatigue, and possibly a headache (signs of mastitis, a breast
infection).
• You have signs of postpartum depression, such as being unable to sleep even when your baby sleeps,
having any thoughts of harming your child, crying all day long for several days in a row, or having panic
attacks.
How to recover more quickly:
• Get as much rest as you can, and make an effort to sleep when your baby sleeps. This can be tough
advice to follow, especially during the day, but it really helps.
• Limit visitors and the time you spend with them. Consider turning off the phone and posting a "we're
napping" message on your door to discourage drop-ins.
• Eat a well-balanced diet.
• Drink plenty of fluids. Avoid caffeine, alcohol, and sugared sodas.
• Accept all offers for help with cooking, cleaning, childcare, errands, and the like. If you aren't receiving
offers, ask for help. It's hard, but trust us, your friends and family want to help and most will be honored
you asked. If you can't get help for free, consider hiring a mother's helper, cleaning lady, or others who
can give you a break.
• Don't isolate yourself. Talking to friends, relatives, and other new moms about your birth experience
and life with a newborn can help you cope.
If you're planning to breastfeed and haven't bought nursing bras yet, now is the time. Bring them to the
hospital — you'll want them for comfort and support. Your breasts are likely much larger now than pre-
pregnancy, and they'll probably increase one or two more sizes while you're nursing. While you're
shopping, get some breast pads to tuck into your bra to absorb any leaks and some purified or "medical-
grade" lanolin ointment for tender nipples. (Avoid lanolin if you're allergic to wool.)

See the big picture

It's hard to say for sure how big your baby will be, but the average newborn weighs about 7 1/2 pounds
(a small pumpkin) and is about 20 inches long. His skull bones are not yet fused, which allows them to
overlap a bit if it's a snug fit through the birth canal during labor. This so-called "molding" is the reason
your baby's noggin may look a little conehead-ish after birth. Rest assured — it's normal and temporary.

After months of anticipation, your due date rolls around, and... you're still pregnant. It's a frustrating, but
common, situation in which to find yourself. You may not be as late as you think, especially if you're
relying solely on a due date calculated from the day of your last period because sometimes women
ovulate later than expected. Even with reliable dating, some women have prolonged pregnancies for no
apparent reason.
You still have a couple of weeks before you'll be considered "post-term." But to be sure your baby is still
thriving, your practitioner will schedule you for testing to keep an eye on her if your pregnancy
continues.
You may have a biophysical profile (BPP), which consists of an ultrasound to look at your baby's overall
movements, breathing movements (movement of her chest muscles and diaphragm), and muscle tone
(whether she opens and closes her hand or extends and then flexes her limbs), as well as the amount of
amniotic fluid that surrounds her (important because it's a reflection of how well the placenta is
supporting your baby).
Fetal heart rate monitoring (called a nonstress test or NST) will generally be done as well — by itself or
as part of the BPP. Or, you may have what's known as a modified BPP, which consists of an NST and an
ultrasound to assess the amount of amniotic fluid.
If the fetal testing isn't reassuring — the amniotic fluid level is too low, for example — you'll be induced.
If there's a serious, urgent problem, you may have an immediate c-section.
Your practitioner will also check your cervix to see if it's "ripening." Its position, how soft it is, how
effaced (thinned out) it is, and how dilated (open) it is can all affect when and how your labor is induced.
If you don't go into labor on your own, you'll be induced, usually sometime between 41 and 42 weeks.
3 Questions About...Inducing labor
Q1.
What does it mean to induce labor?
If your labor doesn't start on its own, your practitioner can use certain medications and techniques to
help bring on or "induce" contractions. She'll do this when the risks of prolonging your pregnancy are
higher than the risks of induction. Most practitioners will induce labor if you're still pregnant between one
and two weeks after your due date. This is because the placenta may become less effective at
delivering nutrients at around 42 weeks, and other serious complications become more likely as you
pass your due date.
Q2.
How is labor induced?
There are a variety of methods, and the one your practitioner uses will depend on your individual
situation — in part, on the condition of your cervix (whether it's ripe or not) and the urgency of the
induction.
Typically, if you need to be induced but your cervix is not yet dilated or thinned out, you'll be admitted to
the hospital and your caregiver will likely start off the induction by inserting medication that contains
prostaglandins into your vagina. This medication helps to ripen the cervix and may also stimulate
enough contractions to start your labor.
If the prostaglandins don't put you into labor, your caregiver will then administer a drug called Pitocin
(also known as oxytocin). It's given through an IV and used to start labor or augment contractions you've
been having on your own. (If your cervix is ripe to begin with, she'll start with the Pitocin straightaway.)
Q3.
Are there any techniques for kickstarting labor that I can try myself?
There are no do-it-yourself techniques consistently proven to be both safe and effective so don't try
anything without guidance from your caregiver. Here's the scoop on some of the methods you may have
heard about:
• Sexual intercourse: Semen contains prostaglandins and having an orgasm may stimulate some
contractions. A few studies have shown that having sex at term may decrease the need for labor
induction, but others have shown it has no effect on promoting labor.
• Nipple stimulation: Stimulating your nipples releases oxytocin, and it may help start labor, but more
research is needed to determine the safety and effectiveness of this method. Because it may
overstimulate your uterus, your contractions and your baby's response to them would need to be
monitored so don't try this at home.
• Castor oil is a strong laxative, and stimulating your bowels may cause some contractions. There's no
definitive proof that it helps induce labor though plenty of women can attest to its unpleasant effects!
• Herbal remedies: A variety of herbs are touted as useful for labor induction. Some are risky because
they can cause contractions that are too long or too strong and may be unsafe for your baby for other
reasons as well. For others, the safety and effectiveness remain unknown.
Kick back and relax. Rent some movies, read a novel, curl up with a stack of magazines or a new CD,
sleep in or grab catnaps when you can.You're in the final stretch and you deserve some downtime! If
you're go-go-go right up until delivery you'll be depleted by the time your baby arrives, says clinical
psychologist Diane Sanford.
See the big picture

A bit over 20 inches long, your baby has continued to grow and may now weigh almost 8 pounds. As
cozy as he is, your baby can't stay inside you forever. For your baby's safety, your practitioner will talk
with you about inducing labor if your baby isn't born in the next week — earlier if there are any
problems. Most practitioners won't let you wait more than two weeks past your due date to give birth
because it puts you and your baby at increased risk for complications. About 5 to 6 percent of women
have prolonged pregnancies that extend three or more weeks beyond their estimated due dates. Babies
born at 42 weeks and beyond can have dry parchment-like skin and are often overweight. Waiting that
long to deliver also increases your chance of developing an infection in your uterus that could be
dangerous for your baby or of having a stillbirth. What's more, your labor is more likely to be prolonged
or stalled, both you and your baby have an increased risk of injury during a vaginal delivery, and you
double your chances of needing a c-section.
Note: Experts say every baby develops differently — even in utero. This developmental information is
designed to give you a general idea of how your baby is growing in your womb.
How your life is changing:

It's hard not to be anxious when your due date comes and goes and you're still hugely pregnant
(especially when well-meaning family and friends keep calling to check on your status!). But don't fret —
you won't be pregnant forever. There's a good chance you'll go into labor on your own this week, and if
you don't, you'll be induced by 42 weeks, or earlier if you or your baby has any problems.
The methods your practitioner uses to induce labor will depend on the condition of your cervix. If your
cervix hasn't started to soften, efface (thin out), or dilate (open), it's considered "unripe," or not yet ready
for labor. In that case, your practitioner will use either hormones or "mechanical" methods to ripen your
cervix before the induction. Sometimes these will end up jump-starting your labor as well. Depending on
your situation, the procedures can include stripping or rupturing your membranes, or using drugs like
oxytocin (Pitocin) to start your contractions. If these and other methods don't work, you'll end up having
a c-section.
In the meantime, be sure to tell your practitioner immediately if your baby's movements slow down or if
any fluid is leaking from your vagina.
Your newborn
Because he was curled up inside your uterus until recently, your newborn baby will probably look
scrunched up for a while, with his arms and legs not fully extended. He may even appear bowlegged.
Don't worry: Your baby will stretch out, little by little, and by the time he reaches 6 months, he'll be fully
unfurled! In the meantime, as he adjusts to life outside the warm, safe confines of your womb, he may
enjoy being swaddled in a light blanket.
• Learn more fascinating facts about your newborn's development.
Your life: You're a parent!
This week, reality sets in — you have a baby! He's all yours, he's home with you, and he's dependent on
you for love, care, and feeding. No doubt you've been reading up on what to do and how to do it. We
have plenty of articles and tools to refresh your memory and teach you new tips, but here's our best
advice this week: Don't try to master the art of caring for a baby all at once. Take it easy, take it slow.
Your newborn is more durable than you might think. He's getting used to you as much as you and your
partner are getting used to him. Like all good relationships, this one will take some time.

Your Pregnancy

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