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Woman’s pregnancy: Stages of pregnancy | Office on Women’s Health

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Pregnancy – week by week

The unborn baby spends around 38 weeks in the womb, but the average length of pregnancy (gestation) is counted as 40 weeks. This is because pregnancy is counted from the first day of the woman’s last period, not the date of conception, which generally occurs two weeks later.

Pregnancy is divided into three trimesters:

  • First trimester – conception to 12 weeks
  • Second trimester – 12 to 24 weeks
  • Third trimester – 24 to 40 weeks.

Conception

The moment of conception is when the woman’s ovum (egg) is fertilised by the man’s sperm. The gender and inherited characteristics are decided in that instant.

Week 1

This first week is actually your menstrual period. Because your expected birth date (EDD or EDB) is calculated from the first day of your last period, this week counts as part of your 40-week pregnancy, even though your baby hasn’t been conceived yet.

Week 2

Fertilisation of your egg by the sperm will take place near the end of this week.

Week 3

Thirty hours after conception, the cell splits into two. Three days later, the cell (zygote) has divided into 16 cells. After two more days, the zygote has migrated from the fallopian tube to the uterus (womb). Seven days after conception, the zygote burrows itself into the plump uterine lining (endometrium). The zygote is now known as a blastocyst.

Week 4

The developing baby is tinier than a grain of rice. The rapidly dividing cells are in the process of forming the various body systems, including the digestive system.

Week 5

The evolving neural tube will eventually become the central nervous system (brain and spinal cord).

Week 6

The baby is now known as an embryo. It is around 3 mm in length. By this stage, it is secreting special hormones that prevent the mother from having a menstrual period.

Week 7

The heart is beating. The embryo has developed its placenta and amniotic sac. The placenta is burrowing into the uterine wall to access oxygen and nutrients from the mother’s bloodstream.

Week 8

The embryo is now around 1.3 cm in length. The rapidly growing spinal cord looks like a tail. The head is disproportionately large.

Week 9

The eyes, mouth and tongue are forming. The tiny muscles allow the embryo to start moving about. Blood cells are being made by the embryo’s liver.

Week 10

The embryo is now known as a fetus and is about 2.5 cm in length. All of the bodily organs are formed. The hands and feet, which previously looked like nubs or paddles, are now evolving fingers and toes. The brain is active and has brain waves.

Week 11

Teeth are budding inside the gums. The tiny heart is developing further.

Week 12

The fingers and toes are recognisable, but still stuck together with webs of skin. The first trimester combined screening test (maternal blood test + ultrasound of baby) can be done around this time. This test checks for trisomy 18 (Edward syndrome) and trisomy 21 (Down syndrome).

Week 13

The fetus can swim about quite vigorously. It is now more than 7 cm in length.

Week 14

The eyelids are fused over the fully developed eyes. The baby can now mutely cry, since it has vocal cords. It may even start sucking its thumb. The fingers and toes are growing nails.

Week 16

The fetus is around 14 cm in length. Eyelashes and eyebrows have appeared, and the tongue has tastebuds. The second trimester maternal serum screening will be offered at this time if the first trimester test was not done (see week 12).

Week 18-20

An ultrasound will be offered. This fetal morphology scan is to check for structural abnormalities, position of placenta and multiple pregnancies. Interestingly, hiccoughs in the fetus can often be observed.

Week 20

The fetus is around 21 cm in length. The ears are fully functioning and can hear muffled sounds from the outside world. The fingertips have prints. The genitals can now be distinguished with an ultrasound scan.

Week 24

The fetus is around 33 cm in length. The fused eyelids now separate into upper and lower lids, enabling the baby to open and shut its eyes. The skin is covered in fine hair (lanugo) and protected by a layer of waxy secretion (vernix). The baby makes breathing movements with its lungs.

Week 28

Your baby now weighs about 1 kg (1,000 g) or 2 lb 2oz (two pounds, two ounces) and measures about 25 cm (10 inches) from crown to rump. The crown-to-toe length is around 37 cm. The growing body has caught up with the large head and the baby now seems more in proportion.

Week 32

The baby spends most of its time asleep. Its movements are strong and coordinated. It has probably assumed the ‘head down’ position by now, in preparation for birth.

Week 36

The baby is around 46 cm in length. It has probably nestled its head into its mother’s pelvis, ready for birth. If it is born now, its chances for survival are excellent. Development of the lungs is rapid over the next few weeks.

Week 40

The baby is around 51 cm in length and ready to be born. It is unknown exactly what causes the onset of labour. It is most likely a combination of physical, hormonal and emotional factors between the mother and baby.

Where to get help

  • Your doctor
  • Obstetrician
  • Midwife

Things to remember

  • Pregnancy is counted as 40 weeks, starting from the first day of the mother’s last menstrual period. Your estimated date to birth is only to give you a guide. Babies come when they are ready and you need to be patient.
  • The gender and inherited characteristics of the baby are decided at the moment of conception.

10 Things That Might Surprise You About Being Pregnant (for Parents)

Pregnancy info is everywhere. At your first prenatal visit, your doctor will likely give you armfuls of pamphlets that cover every test and trimester.

Despite all this information, here are 10 common surprises that pregnancy can bring.

1. The Nesting Instinct

Many pregnant women feel the nesting instinct, a powerful urge to prepare their home for the baby by cleaning and decorating.

As your due date draws closer, you may find yourself cleaning cupboards or washing walls — things you never would have imagined doing in your ninth month of pregnancy! This desire to prepare your home can be useful — you’ll have fewer to-do items after the birth. But be careful not to overdo it.

2. Problems With Concentration

In the first trimester, tiredness and morning sickness can make many women feel worn out and mentally fuzzy. But even well-rested pregnant women may have trouble concentrating and periods of forgetfulness.

Thinking about the baby plays a role, as do hormonal changes. Everything — including work, bills, and doctor appointments — may seem less important than the baby and the coming birth. Making lists can help you remember dates and appointments.

3. Mood Swings

Premenstrual syndrome and pregnancy are alike in many ways. Your breasts swell and become tender, your hormones go up and down, and you may feel moody. If you have PMS, you’re likely to have more severe mood swings during pregnancy. They can make you go from being happy one minute to feeling like crying the next.

Mood swings are very common during pregnancy. They tend to happen more in the first trimester and toward the end of the third trimester.

Many pregnant women have depression during pregnancy. If you have symptoms such as sleep problems, changes in eating habits, and mood swings for longer than 2 weeks, talk to your health care provider.

4. Bra Size

An increase in breast size is one of the first signs of pregnancy. Breast growth in the first trimester is due to higher levels of the hormones

estrogenand
progesterone. That growth in the first trimester might not be the end, either — your breasts can continue to grow throughout your pregnancy!

Your bra size also can be affected by your ribcage. When you’re pregnant, your lung capacity increases so you can take in extra oxygen, which may lead to a bigger chest size. You may need to replace your bras several times during your pregnancy.

5. Skin Changes

Do your friends say you have that pregnancy glow? It’s one of many effects that can come from hormonal changes and your skin stretching.

Pregnant women have increased blood volume to provide extra blood flow to the uterus and  other organs, especially the kidneys. The greater volume brings more blood to the vessels and increases oil gland secretion.

Some women develop brownish or yellowish patches called chloasma, or the “mask of pregnancy,” on their faces. And some will notice a dark line on the midline of the lower abdomen, known as the linea nigra (or linea negra). They can also have hyperpigmentation (darkening of the skin) of the nipples, external genitalia, and anal region. That’s because pregnancy hormones cause the body to make more pigment.

This increased pigment might not be even, so the darkened skin may appear as splotches of color. Chloasma can’t be prevented, but wearing sunscreen and avoiding UV light can minimize its effects.

Acne is common during pregnancy because the skin’s sebaceous glands make more oil. And moles or freckles that you had before pregnancy may get bigger and darker. Most of these skin changes should go away after you give birth.

Many pregnant women also get heat rash, caused by dampness and sweating. In general, pregnancy can be an itchy time for a woman. Skin stretching over the abdomen may cause itchiness and flaking. Your doctor can recommend creams to soothe dry or itchy skin.

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6. Hair and Nails

Many women have changes in hair texture and growth during pregnancy. Hormones can make your hair grow faster and fall out less. But these hair changes usually aren’t permanent. Many women lose some hair in the postpartum period or after they stop breastfeeding.

Some women find that they grow hair in unwanted places, such as on the face or belly or around the nipples. Changes in hair texture can make hair drier or oilier. Some women even find their hair changing color.

Nails, like hair, can change during pregnancy. Extra hormones can make them grow faster and become stronger. Some women, though, find that their nails split and break more easily during pregnancy. Like the changes in hair, nail changes aren’t permanent. If your nails split and tear more easily when you’re pregnant, keep them trimmed and avoid the chemicals in nail polish and nail polish remover.

7. Shoe Size

Even though you can’t fit into any of your pre-pregnancy clothes, you still have your shoes, right? Maybe — but maybe not. Extra fluid in their pregnant bodies mean that many women have swollen feet and need to wear a larger shoe size. Wearing slip-on shoes in a larger size can be more comfortable, especially in the summer months.

8.

Joint Mobility

During pregnancy, your body makes the hormone relaxin, which is believed to help prepare the pubic area and the cervix for the birth. Relaxin loosens the ligaments in your body, making you less stable and more at risk for injury. It’s easy to overstretch or strain yourself, especially the joints in your pelvis, lower back, and knees. When exercising or lifting objects, go slowly and avoid sudden, jerking movements.

9. Varicose Veins, Hemorrhoids, and Constipation

Varicose veins, usually found in the legs and genital area, happen when blood pools in veins enlarged by pregnancy hormones. Varicose veins often go away after pregnancy. To help prevent them:

  • avoid standing or sitting for long periods
  • wear loose-fitting clothing
  • wear support hose
  • raise your feet when you sit

Hemorrhoids — varicose veins in the rectum — are common during pregnancy as well. Your blood volume has increased and your uterus puts pressure on your pelvis. So the veins in your rectum may enlarge into grape-like clusters. Hemorrhoids can be very painful, and can bleed, itch, or sting, especially during or after a bowel movement (BM).

Constipation is another common pregnancy woe. It happens because pregnancy hormones slow the passing of food through the gastrointestinal tract. During the later stages of pregnancy, your uterus may push against your large intestine, making it hard for you to have a BM. And constipation can contribute to hemorrhoids because straining to go may enlarge the veins of the rectum.

The best way to deal with constipation and hemorrhoids is to prevent them. Eating a fiber-rich diet, drinking plenty of liquids daily, and exercising regularly can help keep BMs regular. Stool softeners (not laxatives) may also help. If you do have hemorrhoids, talk to your health care provider about a cream or ointment that can shrink them.

10. Things That Come Out of Your Body During Labor

So you’ve survived the mood swings and the hemorrhoids, and you think your surprises are over. But the day you give birth will probably hold the biggest surprises of all.

During pregnancy, fluid surrounds your baby in the amniotic sac. This sac breaks (or “ruptures”) at the start of or during labor — a moment usually referred to as your water breaking. For most women in labor, contractions start before their water breaks. Sometimes the doctor has to rupture the amniotic sac (if the cervix is already dilated).

How much water can you expect? For a full-term baby, there are about 2 to 3 cups of amniotic fluid. Some women may feel an intense urge to pee that leads to a gush of fluid when their water breaks. Others may only feel a trickling down their leg because the baby’s head acts like a stopper to prevent most of the fluid from leaking out.

Amniotic fluid is generally sweet-smelling and pale or colorless. It’s replaced by your body every 3 hours, so don’t be surprised if you continue to leak fluid, about a cup an hour, until delivery.

Other, unexpected things may come out of your body during labor. Some women have nausea and vomiting. Others have diarrhea before or during labor, and passing gas is also common. During the pushing phase of labor, you may lose control of your bladder or bowels.

A birth plan can help communicate your wishes to your health care providers about how to handle these and other aspects of labor and delivery.

Lots of surprises are in store for you when you’re pregnant — but none sweeter than the way you’ll feel once your newborn is in your arms!

4 Common Pregnancy Complications | Johns Hopkins Medicine

When you find out you’re pregnant, your thoughts and emotions may go into
overdrive. You might be as excited about this new person you will bring
into the world as you are terrified that something may go wrong.

Most pregnancies progress without incident. But approximately 8 percent of all pregnancies involve complications that, if left untreated, may harm the mother or the baby. While some complications relate to health problems that existed before pregnancy, others occur unexpectedly and are unavoidable.

It can be scary to hear that doctors have diagnosed a complication. You may be worried about your baby’s health and your own health. You may even feel panic that perhaps something you did (or didn’t do) caused this to happen. These feelings are completely normal. It may reassure you to know that nothing you did caused these complications. And beyond that —these complications are treatable. The best thing you can do for you and your baby is to get prenatal care from a provider you trust. With early detection and proper care, you increase the chances of keeping you and your baby healthy.

A Johns Hopkins obstetrician discusses some common pregnancy complications and how they can be managed.

Hyperemesis Gravidarum

What is it? While many pregnant women experience morning sickness (nausea, possibly with vomiting, generally in the morning hours) and other discomforts during pregnancy , women with hyperemesis gravidarum (HG) have morning sickness times 1,000. HG is severe nausea that results in significant weight loss and may require hospitalization. (Though it may not make you feel any better, know that if you have HG, you are in royal company — Her Royal Highness The Duchess of Cambridge, Kate Middleton, suffered from it.)

What are the symptoms? Women with HG have severe nausea and vomiting. The vomiting and reduced appetite leads to weight loss and dehydration. The major difference between HG and normal morning sickness is that HG results in a weight loss of 5 percent or more of your pre-pregnancy weight.

Who is at risk? Doctors do not yet fully understand HG, what causes it or who is more likely to experience it.

Can you prevent it? You cannot prevent HG, but you can take steps to control and manage it during your pregnancy. The most important thing you can do for you and your baby is to get regular prenatal care. HG can lead to not getting enough nutrients, which can be harmful to both you and your baby. However, with proper treatment, there are typically no long-term effects to either mom or child after the pregnancy.

How is it treated? If you have been diagnosed with HG, the priority is ensuring you have enough nutrients to keep you and your baby healthy. For some women, a diet of bland foods and fluids may be enough, while others may need to take medication to help relieve the nausea. In severe cases, you may need to be hospitalized to receive nutrients and fluids via intravenous (IV) line. You may feel down about having to be in the hospital during your pregnancy. But remember that you are just doing what you need to do to protect your and your baby’s health!

Many women start to feel better by the 20th week of pregnancy, while some continue to experience symptoms throughout the entire pregnancy.

What should I ask my doctor? If you’ve had HG in the past, talk to your doctor when you are thinking about getting pregnant again. It’s important to make sure you are physically, emotionally and psychologically ready to begin another pregnancy. If you had severe weight loss or other nutritional deficiencies, you’ll need to talk to your doctor about making sure you are healthy before getting pregnant.

Gestational Diabetes

What is it? Diabetes is a condition that prevents your body from breaking down sugar. Gestational diabetes mellitus (GDM) is a type of diabetes that occurs during pregnancy. One of the biggest risks of gestational diabetes is that your baby may grow much larger than normal, a condition called macrosomia. During delivery, a baby’s shoulders can get stuck. If the baby is thought to be too big for a safe vaginal delivery, your doctor will recommend a cesarean section .

What are the symptoms? Gestational diabetes has no outward signs or symptoms. Doctors screen for it between 24 and 28 weeks of pregnancy, or earlier in high-risk women such as those who are overweight or have a history of gestational diabetes.

Who is at risk? Risk factors for gestational diabetes include being overweight or having a history of GDM in previous pregnancies. If you are at high risk, your doctor will screen for GDM earlier than 24 weeks, typically in the first trimester.

Can you prevent it? Losing weight before pregnancy, sticking to a healthy diet and getting regular exercise can lower your risk of developing GDM.

How is it treated? You and your doctor should discuss how you can best control the GDM. Good old diet and exercise seem to be a good place to start. A very high percentage of gestational diabetes can be controlled by diet. Still, some women with GDM will need to take medications (pills or even insulin) to control blood sugar levels.

Exercise during pregnancy , even just walking 30 minutes a day, is also great for controlling blood sugar. It’s best to do something you enjoy so you’ll stick with it, but you should let your doctor know what type of exercise you are doing.

What should I ask my doctor? If you’ve had GDM, you and your baby are both at risk of developing type 2 diabetes later in life. So talk to your doctor about steps you can take to reduce that risk.

Placenta Previa

What is it? While you are pregnant, the placenta provides your baby with oxygen and nutrients for proper development. The placenta normally attaches to the upper part of the uterus, but in placenta previa it either totally or partially covers the cervix (which is the opening between the uterus and vagina).

Who is at risk? You may be at higher risk if you have scarring on your uterus from previous pregnancies or from a uterine surgery, or if you have fibroids .

What are the symptoms? The main symptom is vaginal bleeding that is not accompanied by cramping or other pain. Some women, however, do not experience any symptoms. Your doctor will confirm a diagnosis using an ultrasound or physical exam.

Can you prevent it? There’s nothing you can do to prevent placenta previa. However, you can increase your and your baby’s health by getting regular prenatal care. If you are at high risk — because of a previous surgery, C-section or fibroids — make sure to tell your doctor. He or she may want to monitor you more closely during your pregnancy.

How is it treated? Placenta previa may result in bleeding during pregnancy. Some women have no bleeding, some have spotting and others may experience heavy bleeding. If the bleeding is heavy, you may need to stay in the hospital for a period of time. Women with placenta previa will require a C-section to deliver the baby, usually scheduled two to four weeks before their due date.

What should I ask my doctor? Always talk to your doctor if you notice any vaginal bleeding at any point during your pregnancy.

Preeclampsia

What is it? Preeclampsia is a condition that causes dangerously high blood pressure. It can be life-threatening if left untreated. Preeclampsia typically happens after 20 weeks of pregnancy, often in women who have no history of high blood pressure.

What are the symptoms? Symptoms of preeclampsia may include severe headache, vision changes and pain under the ribs. However, many women don’t feel symptoms right away. The first alert is usually when a woman comes in for a routine prenatal visit and has high blood pressure. In those cases, your doctor will test for things like kidney and liver function to determine whether it’s preeclampsia or just high blood pressure .

Who is at risk? Risk factors for preeclampsia include having a history of high blood pressure, being obese (having a body mass index, or BMI, greater than 30), age (teenage mothers and those over 40 are at higher risk) and being pregnant with multiples.

Can you prevent it? While you can’t prevent preeclampsia, staying healthy during pregnancy may help. If you have risk factors, experts recommend that you see your obstetrician either before you become pregnant or very early in your pregnancy, so you and your doctor can discuss ways that you can reduce your risk. For example, many women at risk for preeclampsia are prescribed a baby aspirin after the first trimester.

Regular prenatal visits are the best way to control preeclampsia. During those routine visits, your doctor will check your blood pressure. If it’s high, further tests can diagnose the condition so you can start getting the treatment you need.

How is it treated? The condition only goes away once the baby is born, so delivery is the best way to treat preeclampsia. However, delivering the baby too early can put the baby at risk for health problems. The decision about how to treat you will largely depend on how far along the pregnancy is. You may need to be hospitalized so your team can monitor you and your baby closely.

What should I ask my doctor? Your doctor will discuss the risks and benefits of delivering the baby early versus continuing the pregnancy and trying to manage the preeclampsia as long as possible through other methods. After delivery, the condition will go away, but you will be at greater risk for heart disease later in life. Talk to your doctor about what you can do to help reduce and manage those risks.

Pregnancy Complications: The Bottom Line

While these conditions may differ from one another, you may have noticed one common thread: Regular prenatal (even preconception) care is crucial. Women are encouraged to come in for a preconception consult to talk about what they can do to reduce their risks. Being healthy before pregnancy is the best thing you can do for your baby.

Changes in Your Body During Pregnancy: First Trimester

Path to well being

How do I know I’m pregnant?

A missed period is often the first sign of pregnancy. You may have some other physical signs as well. These include mild cramping and a little bleeding when the fertilized egg implants itself in your uterus.

If you’ve missed your period and think you may be pregnant, you can take a home pregnancy test. These tests are very accurate if you take them a few days after you expected to get your period. Call your doctor if the test is positive.

Why do I feel so tired?

Feeling very tired is another common symptom of early pregnancy. Your body is working hard to adjust to all the new physical changes. This can cause extreme fatigue. You may need to sleep longer than usual at night. If possible, you can take short naps during the day. Your energy will most likely return in the second trimester of pregnancy.

What is morning sickness?

Morning sickness consists of nausea and vomiting. It is caused by pregnancy hormones. Many pregnant people have it to some degree in their first trimester. Despite what it sounds, morning sickness can occur at any time of day. Certain foods or smells might make you feel sick and sometimes vomit. Some people seem to feel sicker when their stomachs are empty. Morning sickness usually goes away by the second trimester.

There are over-the-counter vitamins and herbal supplements that may help with morning sickness. Taking vitamin B6 may help with nausea, even though it may not prevent vomiting. Ginger supplements also may relieve nausea.

What other changes can I expect during the first trimester?

Frequent urination. Towards the end of the first trimester, you will feel like urinating more often. This is because your growing uterus pushes on your bladder. You may even leak a little urine when you cough or sneeze.

Lightheadedness. Your body is working overtime to make extra blood to support your baby. This can cause you to feel dizzy or lightheaded. Hunger, weakness, or stress can cause these symptoms as well.

Heartburn. The muscles that break down food become more relaxed during pregnancy. Hormone changes also slow down this process. Food also stays in your stomach longer to give your body more time to absorb nutrients. All these things can cause or worsen heartburn.

Constipation. You should be taking a daily prenatal vitamin that contains iron. The iron in the vitamin can lead to constipation. The slow process of breaking down food also can cause constipation, gas, and bloating. Your doctor may suggest taking fiber supplements or a stool softener to provide relief. Make sure you drink plenty of water (about eight glasses per day). Tell your doctor if you have severe problems. They may switch you to a different prenatal vitamin.

Visible veins. Your body makes extra blood and your heart pumps faster to meet the needs of pregnancy. This can cause the blue veins in your belly, breasts, and legs to become more noticeable. You may develop spider veins on your face, neck, or arms. These are tiny blood vessels that branch out from a central area, like the legs of a spider.

Skin changes. You may notice that your skin looks more rosy and shiny. Some people call this a “pregnancy glow.” It is caused by increased blood circulation. Pregnancy hormones can cause extra oil on your skin. It may cause you to have flares of acne.

Breast changes. Most people notice changes in their breasts early in pregnancy. The hormones in your body change to prepare for breastfeeding. As this occurs, your breasts may feel tender and swollen. You might notice small bumps forming in the area around your nipples. Your breasts will continue to grow and change throughout your pregnancy. They may feel even bigger and fuller later on.

Vaginal changes. The lining of your vagina will become thicker and less sensitive. You may notice a thin, white discharge. This is normal during pregnancy. Mild vaginal bleeding (spotting) is also normal and common. However, you should call your doctor if you have vaginal bleeding. If the bleeding is heavy or painful, go to the emergency room.

A growing belly. Your waistline will begin to expand as your baby and uterus grow larger. Depending on your size before pregnancy, you may not notice this change until the second trimester. It is normal to gain no or little weight in your first trimester.

Emotional symptoms. Your hormones are on overload during pregnancy. You might feel moody, forgetful, or unable to focus. Fatigue and stress can increase these symptoms.

Things to consider

Keep in mind that each pregnancy experience is unique. Even the same person may have different changes in their multiple pregnancies. For each change, your symptoms may be mild or severe. Do not worry if the changes do not happen at a certain time. Talk to your doctor if you have any concerns.

When to see your doctor

Contact your doctor if you think or know you are pregnant. They will make an appointment to confirm your pregnancy and talk to you about prenatal care.

You should also contact your doctor if your morning sickness and vomiting are severe enough to cause weight loss.

Questions to ask your doctor

  • Am I pregnant?
  • How far along am I in my pregnancy?
  • What kinds of physical and emotional changes should I expect?
  • Are my symptoms normal?
  • Are there any risks that I should be aware of?
  • Which prenatal vitamin do you recommend I take?

Resources

American Academy of Family Physicians: Taking Care of You and Your Baby While You’re Pregnant

The Implications of Defining When a Woman Is Pregnant

According to both the scientific community and long-standing federal policy, a woman is considered pregnant only when a fertilized egg has implanted in the wall of her uterus; however, state definitions of pregnancy vary widely. The differences may be more than academic. Debates over emergency contraception have put the question on center stage, with potentially serious implications.

The question of when life begins is an eternal one, debated by philosophers and theologians for centuries, and likely destined to forever elude consensus. However, on the separate but closely related question of when a woman is considered pregnant, the medical community has long been clear: Pregnancy is established when a fertilized egg has been implanted in the wall of a woman’s uterus. The definition is critical to distinguishing between a contraceptive that prevents pregnancy and an abortifacient that terminates it. And on this point, federal policy has long been both consistent and in accord with the scientists: Drugs and devices that act before implantation prevent, rather than terminate, pregnancy.

At the state level, however, definitions of pregnancy—generally, as part of larger measures enacted to regulate abortion or prescribe penalties for assaulting a pregnant woman—vary widely. Some of these laws say that pregnancy begins at fertilization, others at implantation. Several use the term “conception,” which is often used synonymously with fertilization but, medically, is equated with implantation.

To date, none of these laws has been used to restrict access to the array of hormonal contraceptive methods that can sometimes act between fertilization and implantation, but such restrictions are a long-standing goal of at least some antiabortion and anticontraception activists. And although attempts to legislatively impose the belief that pregnancy begins at fertilization have been repeatedly (sometimes narrowly) rebuffed—most recently by Congress in 1998—the current debate over emergency contraception has moved the issue back to center stage once again.

When Does Pregnancy Begin?

Although widespread, definitions that seek to establish fertilization as the beginning of pregnancy go against the long-standing view of the medical profession and decades of federal policy, articulated as recently as during the Bush administration. In fact, medical experts—notably the American College of Obstetricians and Gynecologists (ACOG)—agree that the establishment of a pregnancy takes several days and is not completed until a fertilized egg is implanted in the lining of the woman’s uterus. (In fact, according to ACOG, the term “conception” properly means implantation.) A pregnancy is considered to be established only when the process of implantation is complete (see box, page 8).

When Is a Woman Pregnant?

To be sure, not every act of intercourse results in a pregnancy. First, ovulation (i.e., the monthly release of a woman’s egg) must occur. Then, the egg must be fertilized. Fertilization describes the process by which a single sperm gradually penetrates the layers of an egg to form a new cell (“zygote”). This usually occurs in the fallopian tubes and can take up to 24 hours. There is only a short window during which an egg can be fertilized. If fertilization does not occur during that time, the egg dissolves and then hormonal changes trigger menstruation; however, if fertilization does occur, the zygote divides and differentiates into a “preembryo” while being carried down the fallopian tube toward the uterus. Implantation of the preembryo in the uterine lining begins about five days after fertilization. Implantation can be completed as early as eight days or as late as 18 days after fertilization, but usually takes about 14 days. Between one-third and one-half of all fertilized eggs never fully implant. A pregnancy is considered to be established only after implantation is complete.

Source: American College of Obstetricans and Gynecologists.

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The federal government has long accepted this definition of pregnancy and, by extension, what constitutes its prevention. For example, the federal regulations designed to implement the Hyde Amendment—the provision that blocks the use of public funds to pay for abortion services for low-income women—say that although funding is not available for abortions, it is available for “drugs or devices to prevent implantation of the fertilized ovum.”

Since the 1970s, the Department of Health and Human Services has had an official definition of pregnancy for purposes of establishing certain safeguards when federally funded research involves pregnant women. During President Clinton’s last week in office, his administration published an overhaul of the long-standing rules governing research involving human subjects. Shortly after President Bush came into office, his administration suspended those rules and reissued a regulation of its own at the end of 2001. Like the proposed Clinton regulation, however, the rules promulgated by the Bush administration, which remain in effect today, say that pregnancy “encompasses the period of time from implantation until delivery.”

Evolving State Policy

A review of state laws conduced in April 2005 by The Alan Guttmacher Institute found that 22 states have enacted one or more laws defining “pregnancy.” (Some of these states have adopted an explicit definition of pregnancy, whereas others have done so implicitly, by defining either “fetus” or “unborn child.”) Despite the clear and long-standing medical consensus that pregnancy is not established until implantation, 18 states have enacted provisions premised on the notion that pregnancy begins at fertilization or conception (see table). (Although many of these laws use the imprecise term “conception,” all but five leave it undefined. Significantly, however, all of the five states that do define the term equate it with fertilization.) Six states have provisions defining pregnancy as beginning at implantation, although two of these states include other definitions as well.

State definitions of pregnancy
  Definitions of Pregnancy Found in Statutes on…
Fetal Research Fetal Assault Abortion
Alabama     F, C
Arizona     F
California     I
Colorado     I
Illinois   F F
Kentucky &nbsp C F
Louisiana   F, C, I F, C, I
Massachusetts     F
Minnesota   C F
Missouri     C
Montana     C
Nebraska   C  
Nevada     C
New Mexico C   I
Ohio   F F
Oklahoma     C
South Carolina     C
South Dakota     I
Texas     F
Washington     I
Wisconsin   F C
Wyoming     C
Note: F = pregnancy begins with fertilization, C = conception, and I = implantation.

These provisions are found in different areas of the state legal codes, including those that establish the legal requirements for abortion services (17 states), prescribe penalties for assaulting a pregnant woman (seven states) and restrict fetal research (one state). Most of the 18 states have several different provisions, sometimes across different types of statutes, and sometimes even within the same section of law. Alabama, for example, has seven definitions in its abortion code—three refer to conception and four to fertilization. And some states seem to use the terms conception, fertilization and implantation interchangeably, even though they have different medical meanings and significance. For example, Louisiana’s abortion code and its statutes concerning assault on pregnant women use all three terms, at times within a single definition.

Implicating Contraception

What is motivating this interest and activity is not entirely clear. Certainly, it would appear to stem from the complex politics of the abortion issue and from the long-standing campaign of some antiabortion activists to personify the fetus and portray it, often using language as a powerful tool, as a baby from the moment of fertilization (see box, page 9). In this regard, it is likely that the proponents of the state laws may have been unaware of how the various contraceptive methods actually work, and were probably not taking aim at them directly. In fact, of the 18 states that have some definition of pregnancy as beginning at fertilization or conception, 12 define abortion as the termination of a “known” pregnancy. Furthermore, two of these states (Arizona and Texas) specifically exclude contraceptives from their definitions of abortion, even though they use fertilization as the starting point for pregnancy elsewhere in their statutes.

Language Matters

Legislative activity at both the federal and state levels around the issue of fetal pain highlight how the inconsistency with which terminology is being used in ongoing policy debates could have real-world implications.

Legislation pending in Congress would require that women obtaining abortions after a certain point in pregnancy be told of the capacity of a fetus to feel pain and be offered anesthesia that could be administered directly to the fetus. The legislation repeatedly refers to that point as “20 weeks after fertilization.” Medically, however, a pregnancy is generally “dated” from “gestation,” defined as the time of the woman’s last menstrual period, because that is a date most women can pinpoint. As a result, the federal mandate, should it be enacted, in fact would be effective for what doctors would consider to be a fetus at 22 weeks, rather than at 20 weeks.

Whether that is the case with various state bills is another question. Fetal pain legislation has been introduced in nearly half the states this year, and enacted in Arkansas. Although almost all of these measures, like the federal bill, refer to “20 weeks,” most of them also use the term “gestation” rather than “fertilization.” Whether that means they are aimed at abortions performed at 22 weeks from a woman’s last menstrual period or at 20 weeks from that point is unclear. And in the real world, that two-week difference matters.

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On the other hand, many in the antiabortion movement clearly understand the modes of action for contraceptive methods, especially the hormonal methods (see box, page 10). Understanding that, they have to know that the end result of enforcing a definition that pregnancy begins at fertilization would implicate not just some hormonal methods, but all of them.

This is clearly a cause for discomfort within the ranks of the abortion opponents. Some groups, notably including the National Right to Life Committee, try to avoid the issue entirely, saying they have no position on contraception. But many, including Concerned Women for America and the Secretariat for Pro-Life Activities of the U.S. Conference of Catholic Bishops, are clear and consistent: For them, pregnancy begins at fertilization, and if that “fact” implicates contraception, so be it. As far back as 1981, Judie Brown, long-time president of the American Life League, made the point quite clear in testimony before a congressional committee: “However, once a chemical or device acts to destroy the newly fertilized egg, which is a brand new life, then we are not any longer dealing with a contraceptive. We’re dealing with an abortion.”

Abortion opponents who have sought to promote this view to ensnare contraceptives have often been publicly rebuffed in Congress. In the most high profile instance, the Senate rejected legislation introduced in the early days of the Reagan administration that tried to use a congressional “finding” that life begins at conception as a way to circumvent the need for a constitutional amendment overturning Roe v. Wade and to ban abortion nationwide. One of the most contentious issues in that debate, aside from the obvious question of the propriety of a legislative body making such moral and ethical determinations, was the potential impact of that finding on many commonly used forms of contraception. Testifying about the potential impact of the legislation, George Ryan, then president of ACOG, said, “I believe that it is realistic to assume that the IUD and the low-dose oral contraceptive pills could be considered as abortifacients and therefore declared illegal.” After months of controversy, the measure was defeated by the full Senate in 1982.

In 1998, during consideration of a measure to include coverage of contraceptive services and supplies in the insurance coverage purchased for federal employees and their dependents, Rep. Chris Smith (R-NJ) offered an amendment to exclude coverage of “abortifacients.” During the heated debate, then-Representative (and now Senator) Tom Coburn (R-OK) sought to “clarify” the discussion, by insisting that the measure would only affect IUDs and emergency contraception, but not any type of oral contraceptives, despite the clear statements by the Food and Drug Administration (FDA) that they also can act after fertilization to prevent implantation.

Rep. Nancy Johnson (R-CT) took the measure on directly, making the science behind the provision, and the motivation for it, quite clear: “Is there no limit to my colleague’s willingness to impose his concept of when life begins on others? Conception is a process. Fertilization of the egg is part of that process. But if that fertilized egg does not get implanted, it does not grow.…For those who do not believe that life begins upon fertilization, but believe, in fact, that that fertilized egg has to be implanted, the gentleman is imposing his judgment as to when life begins on that person and, in so doing, denying them what might be the safest means of contraception available to them.” The amendment was defeated, 198 to 222.

Implications for Emergency Contraception

The ongoing debate over emergency contraception has put the question of the dividing line between preventing and disrupting pregnancy back in the public eye. A product packaged specifically to be used as emergency contraception was first approved by the FDA in 1998 as a method of pregnancy prevention; the agency approved a second such product, Plan B, a year later. In a question-and-answer document developed in 2004, the FDA was explicit in describing the drug’s method of action: “Plan B works like other birth control pills to prevent pregnancy. Plan B acts primarily by stopping the release of an egg from the ovary (ovulation). It may prevent the union of sperm and egg (fertilization). If fertilization does occur, Plan B may prevent a fertilized egg from attaching to the womb (implantation).” In short, despite the confusion that opponents have fostered surrounding emergency contraception’s mode of action, how the method works depends more on when during a woman’s monthly menstrual cycle it is taken (and, specifically, whether she has ovulated) than on when she had sexual intercourse.

Yet, attempting to capitalize on this confusion, some antiabortion advocates took the FDA’s statement as an admission validating their view that because emergency contraception can act after fertilization to prevent implantation, it must clearly be an abortifacient. For example, the bishops asked, “‘How is this contraception?’ Women are being falsely led to believe that these pills are contraceptive in nature. But one of their common and intended modes of action is to prevent the development of the embryo, resulting in his or her death.”

Whether abortion opponents will seek to “activate” existing state laws defining pregnancy for the purpose of restricting access to contraction—or seek to add new definitions for that specific purpose—remains to be seen. It is clear, however, that they have taken direct aim at emergency contraception, and are seeking to separate it from other contraceptive methods, no matter that the science says otherwise.

This effort is making its most public appearance in the controversy raging over whether and to what extent pharmacists must provide emergency contraception. But two less-noticed developments in the states this year are worth noting. First, a measure mandating contraceptive coverage in private insurance plans in Arkansas specifically excludes emergency contraception. Similarly, a measure recently enacted in Indiana that directs the state to apply to the federal government to expand eligibility for Medicaid-covered family planning services excludes “a drug or device intended to terminate a pregnancy after fertilization” from the package that would be covered. The ultimate impact of this provision may hinge on the use of the word “intend,” since it is clear that emergency contraception’s primary mode of action is to act prior to fertilization and its intent is not to act subsequent to that point. But nonetheless, this campaign has ominous implications for emergency contraception and, if carried to its logical conclusion, for contraception in general.

How Do Contraceptives Prevent Pregnancy?

Food and Drug Administration–approved contraceptive drugs and devices act to prevent pregnancy in one or more of three major ways: by suppressing ovulation, by preventing fertilization of an egg by a sperm or by inhibiting implantation of a fertilized egg in the uterine lining. Male and female condoms always act by preventing fertilization; however, the mode of action of any hormonal method may vary not only from woman to woman, but also for an individual woman from month to month, depending on the timing of intercourse in relation to ovulation.

•The primary mechanism of action of “combined” oral contraceptives (those containing both estrogen and a progestin) is the suppression of ovulation. In addition, these pills may interfere with sperm and egg transport, affect the fluids within a woman’s reproductive tract or affect sperm maturation or the readiness of the uterine lining for implantation.

•Progesterone-only pills and injectables can suppress ovulation; however, other modes of action that inhibit fertilization and implantation are considered more important for these methods than for methods containing estrogen. For example, progestin-only methods can cause a woman’s cervical mucus to thicken, reducing sperm and egg transport; interfere with sperm maturation; or decrease the readiness of the uterine lining for implantation.

•As with other hormonal contraceptives, there is no single mechanism of action for emergency contraception. The method is considered to act mainly by suppressing ovulation; it may also reduce sperm and egg transport or decrease the readiness of the uterine lining for implantation.

•The primary mode of action for IUDs is inhibition of fertilization, by causing the cervical mucus to thicken (for progesterone-releasing IUDs) or by altering the fluids in the fallopian tubes and uterus (for copper-releasing IUDs). In addition, IUDs affect the lining of the uterus in a way that may be unfavorable for implantation.

In summary, according to the American College of Obstetricians and Gynecologists, “the primary contraceptive effect of all the non-barrier methods, including emergency use of contraceptive pills, is to prevent ovulation and/or fertilization. Additional contraceptive actions for all of these also may affect the process beyond fertilization but prior to pregnancy.”

Source: The American College of Obstetricians and Gynecologists.

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A Pregnant Woman’s Daily Diet

At no other time in life is nutrition as important as before, during, and following pregnancy. On the other hand, women can still eat foods that come in a box or a bag, eat out several times a week, or order pizza to go as long as they also follow a few simple eating-for-two dietary guidelines.

A Pregnant Woman Should Include in Their Daily Diet at Least:

  • Five servings of fresh fruits and vegetables (including at least one serving of a dark orange vegetable, two servings of dark green leafy vegetables, and one serving of citrus fruit)
  • Six servings of enriched, whole-grain breads and cereals. Three servings of nonfat or low-fat milk or milk products
  • Two to three servings of extra-lean meats, chicken without the skin, fish, or cooked dried beans and peas
  • Eight glasses of water

The guidelines for eating well for a healthy pregnancy are simple and easy to follow. When, where, and how much they eat is flexible, and often is governed by necessity. A pregnant woman in their first trimester might choose a snack for breakfast and a large evening meal if they suffer from morning sickness, but select a larger breakfast and a light evening meal in the last trimester when heartburn is more of a problem. Avoid or limit caffeine (such as coffee, tea, and colas) and avoid alcohol and tobacco. Since no safe limit has been established for alcohol, abstinence is a woman’s best bet.

A Weighty Issue

If a woman does not gain enough weight, their baby also won’t gain enough weight, which places the newborn at high risk for health problems. Optimal weight gains of 25 to 35 pounds in a slender woman helps ensure a healthy-sized baby. Underweight women should gain more weight, or approximately 28 to 40 pounds. Overweight women should not attempt to use pregnancy as a way to use up extra body fat, since stored body fat is not the stuff from which babies are made. A modest weight gain of between 12 to 25 pounds is recommended for these women.

Further weight gain beyond recommended amounts will not make bigger or healthier babies. It will make regaining a desirable figure more difficult after delivery. The secret is to pace the gain, with weight gain increasing from very little in the first trimester to as much as a pound a week in the last two months of pregnancy.

Folic Acid: It’s a Must

Nutrition experts agree that the best place for the mother-to-be to get all the essential nutrients, including ample amounts of vitamins and minerals, is from their diet. The trick is getting enough. For example, the MRC Vitamin Study at the Medical College of St. Bartholomew’s Hospital in London found that women taking folic acid supplements around conception had significantly lower risks for giving birth to babies with neural tube defects (NTD), a type of birth defect where the embryonic neural tube that forms the future brain and spinal column fails to close properly.

Luckily, in 1996 the U.S. Food and Drug Administration (FDA) issued a regulation requiring that all enriched grain products, including breads and pasta, be supplemented with folic acid. Every woman during the childbearing years should make sure they get at least 400 micrograms of folic acid from food or supplements.

The Post-Pregnancy Diet

Whether a woman breastfeeds or not, the secret to post-pregnancy nutrition is to gradually regain a desirable figure, while maintaining or restocking nutrient stores. In addition, since some babies are planned and others are surprises, it’s never too late to start nourishing the next baby by continuing to eat a diet based on fresh fruits and vegetables, nonfat milk products, whole grains, and protein-rich beans and meats.

Pregnancy & Sleep: Tips, Sleep Positions, & Issues

For many women, sleep can be evasive during pregnancy. Physical discomfort, changing hormones, and excitement and anxiety about being a new mother lead to a host of sleep problems. In fact, it’s believed that at least 50 percent of pregnant women suffer from insomnia.

Sleep is an essential part of prenatal care. If you’re struggling to sleep well during pregnancy, you’re not alone. We’ll discuss common sleep problems for pregnant women, take a look at the best pregnancy sleeping positions, and share advice on how to get the best sleep possible during pregnancy.

Why Does Sleep Change During Pregnancy?

A multitude of factors leads to insomnia during pregnancy. Beginning in the first trimester, fluctuating hormone levels cause generalized discomfort and other problems that can make it difficult to fall asleep and stay asleep. These may include:

  • Nausea
  • Vomiting
  • Breast tenderness
  • Increased heart rate
  • Shortness of breath
  • Higher body temperature
  • Frequent nighttime urination
  • Leg cramps

As time wears on, expectant mothers may also experience back pain and have trouble finding a comfortable position to accommodate the growing baby bump, especially when the baby starts to kick at night. Anxiety about the upcoming labor, being a new mother, juggling work and home responsibilities, or other worries may keep your mind racing at night. In the third trimester, many pregnant women experience vivid, disturbing dreams that can further impair sleep quality.

While it’s common for most pregnant women to experience at least a few of the above symptoms, sometimes they may be related to a sleep disorder. Sleep disorders can be linked to further problems down the line for mother or baby, so it’s important to talk to your doctor if you’re experiencing any symptoms.

Common Sleep Disorders and Problems During Pregnancy

The most common sleep disorders that tend to occur during pregnancy are obstructive sleep apnea, restless legs syndrome, and gastroesophageal reflux disorder.

  • Obstructive Sleep Apnea: Weight gain and nasal congestion lead many women to start snoring during pregnancy, which may be a risk factor for high blood pressure. Some women may go on to develop obstructive sleep apnea (OSA), a sleep condition characterized by snoring, gasping, and repeated lapses in breathing that disrupt sleep quality. OSA may impede oxygen flow to the fetus and increase the risk of preeclampsia, gestational diabetes, and cesarean sections. It is thought to affect as many as 1 in 5 women during pregnancy.
  • Restless Legs Syndrome: People with restless legs syndrome (RLS) are plagued by sensations best described as a crawling, tickling, or itching that cause an irrepressible urge to move the legs. This condition can make it difficult to fall asleep, as the symptoms are more severe when the person is at rest. RLS is thought to affect up to one-third of women in their third trimester of pregnancy.
  • Gastroesophageal Reflux Disorder: Otherwise known as heartburn or acid reflux, gastroesophageal reflux disorder (GERD) causes an uncomfortable burning sensation in the esophagus, especially when lying down. It’s a common cause of insomnia in pregnant women across all trimesters, thought to affect one-quarter of pregnant women in the first trimester and as many as one-half in the third. Long-term GERD may damage the esophagus.

Why Is Sleep so Important During Pregnancy?

Getting quality sleep during pregnancy is important for both mother and baby. For the mother, those sleepless nights end up leading to fatigue and daytime sleepiness. Sleep also plays a major role in memory, learning, appetite, mood, and decision-making – all important when preparing to welcome a newborn baby into your home.

Chronic sleep deprivation takes its toll on the immune system. Some researchers believe this may be part of the reason why a lack of sleep has such a significant impact on maternal and fetal health. And since sleep helps regulate blood sugar, it’s not surprising that poor sleep during pregnancy appears to be linked to gestational diabetes mellitus.

Research shows that pregnant women who get too much or not enough sleep in early pregnancy are prone to developing high blood pressure in the third trimester. Severe sleep deprivation in early pregnancy may also raise the risk of preeclampsia, a condition that can lead to preterm delivery and lasting complications for the mother’s heart, kidney, and other organs.

Though more research is needed to control for other variables, poor sleep appears to be a risk factor for preterm birth, low birth weight, painful labor, cesarean delivery, and depression. Emerging evidence also suggests that poor sleep quality during pregnancy may predict sleep problems and crying in babies once they are born.

Treatment for Sleep Problems During Pregnancy

There are a number of ways to reduce sleep problems while pregnant. Principal strategies include adjustments to sleeping position and sleep hygiene habits. In conjunction with good sleep hygiene, managing pregnancy-related sleep disorders is key to getting better sleep while pregnant.

Certain therapies have proven effective for treating sleep disorders, such as a continuous positive airway pressure (CPAP) device for OSA, antacids for GERD, or vitamin and mineral supplements for RLS and other conditions. Although there are many theories, the reason for leg cramps and RLS during pregnancy remains unclear. Suggested therapies include vitamin supplementation, heat therapy, and massage but there is no consensus about what is the best treatment.

As certain substances may pose a risk to the developing fetus, pregnant women should always consult with their doctor before taking any medication or herbal remedies to help with sleep.

Best Sleeping Positions for Pregnancy

Sleeping on the left side with the legs slightly curled is considered the best sleeping position in pregnancy. This position facilitates blood flow to the heart, kidneys, and uterus, and improves the delivery of oxygen and nutrients to the fetus. Although not as optimal as the left side, sleeping on the right side during pregnancy is also acceptable.

It may be helpful to use a few extra pillows to get comfortable sleeping on your side, especially if you’re not accustomed to this sleeping position. Try tucking in a wedge pillow to support your belly, or adding a thin pillow between the knees to help relieve pressure on the lower back. Some women find it useful to hug a body pillow or place a pillow under the lower back.

As the uterus grows larger, sleeping on the back during pregnancy can cause backache and put pressure on the vena cava. The vena cava is one of the body’s principal veins, so this can interfere with blood flow and cause dizziness. While back sleeping is all right for brief stints, it’s best to avoid it if possible. Most pregnant women find that sleeping on the stomach is impractical once the baby bump reaches a certain size.

Sleep Hygiene for Pregnant Women

Sleep hygiene is more important than ever during pregnancy. In addition to pregnancy sleep aids such as specialized pillows or eye masks, the following habits may help reduce insomnia and improve overall sleep quality:

  • Keep a cool, dark, quiet bedroom and limit the bed to sleeping and sex
  • Prioritize sleep and stick to a consistent bedtime, scheduling naps earlier in the day so they don’t interfere with nighttime sleep
  • Read a book, take a bath, or indulge in another calming activity in preparation for bedtime
  • Use a nightlight to make it easier to get back to sleep after bathroom breaks
  • Avoid caffeine, spicy foods, and heavy meals too close to bedtime to reduce the risk of GERD
  • Avoid taking technology into the bedroom, and turn off screens at least an hour before bed
  • Get regular exercise earlier in the day
  • Drink plenty of water throughout the day, but reduce liquid intake before bed to reduce nighttime bathroom breaks
  • If you can’t sleep, get out of bed and do something else until you feel sleepy
  • Write down thoughts in your journal, or seek help from your partner, friends, doctor, or childbirth classes if you’re feeling stressed
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90,000 Emotions and Pregnancy | Official website of the Vologda Regional Psychiatric Hospital

Most people know that pregnancy has its own special aura that cannot be compared with anything else. During pregnancy, life is filled with new meaning and new sensations. Your inner world is enriched with a special inner light, and you have the feeling that you are performing a high and special task. Expectant mothers describe a sense of high responsibility that they have not previously felt.

Despite the fact that the birth of a baby is a longed-for event, the importance of this changes the entire spiritual world of a woman, and makes her think and ask herself all new questions: “How will my life change? How will the pregnancy go? How will my career develop in the future? Will I be able to provide a good future for my child? Will I become a worthy mother? ”

Such mental anxiety can cause loss of strength and changes in emotional sensitivity, as well as the cause of toxicosis or the threat of termination of pregnancy.

The initial period of pregnancy takes place with dramatic changes in the physiology and psychology of women. Not all women find it easy to accept these changes. There is a need to control your feelings. A woman needs to realize what this comes from, what new feelings mean. During this crucial period, psychologists do not recommend solving all issues at the same time. You need to postpone them for a while, and it is likely that the problems will disappear without any effort from the outside.

Pregnancy is a rare period in life when a woman can afford not to react to various life difficulties, not to show a harsh attitude towards them. During this period, a woman can afford not to feel remorse and not feel guilty at the same time. It is important to know that the baby needs your care, affection and love. First, you need to understand and accept your own condition, allow yourself to be pregnant. Understanding your own condition means accepting the fact that your baby is born.

Pregnancy should not be associated with prohibition, this is the moment of your inner freedom. Pamper yourself – you can lie down and relax during the daytime or eat something delicious. Change everything – your old habits and repetitive phrases, for example: don’t say that you can no longer wear tight-fitting trousers, say it’s time to update your wardrobe. You just need to change your perception of the world, and you will immediately find peace.

Pregnancy changes a woman, making her more fragile, restless and sensitive.Even the smallest excuse can upset a pregnant woman. Many women feel trapped by nausea and physical changes. Doctors believe this behavior arises from hormonal changes in the body.

During pregnancy, a woman becomes more irascible and nervous. It is not worth scolding yourself for showing incontinence, you need to learn to avoid unnecessary guilt for your “weakness”. This can be learned in psychological courses at antenatal clinics.Psychologists have come to the conclusion that this condition is a natural sign for the expectant mother. They believe that a woman should definitely relax at such moments. This will help both during pregnancy and during childbirth, and will leave a positive mark throughout your life.

The easiest way to relax at home is to turn on and listen to a pleasant melody. You can enjoy the music while lying down. In this case, you need to focus your attention on breathing. Breathe in and out.You need to imagine that after each exhalation, you relax and find peace. It is necessary to create a pleasant environment that will help you create a harmony of happiness.

The hormone of happiness is endorphin, which is produced by the pineal gland, or pineal gland. Scientists have found that during childbirth, endorphins regulate the contractile work of the uterus, after which the threshold of pain sensitivity changes, because of this, pain sensations decrease and their frequency during childbirth decreases.The hormone endorphin acts on muscle relaxation, under its influence anesthesia occurs, blood circulation improves, and an emotional uplift appears. Endorphins help raise prolactin levels. Prolactin is a hormone that stimulates lactation after childbirth. It helps in feeding the baby.

To increase the production of this hormone, classical music, board games, drawing, pleasant communication, meditation, eating sweets, as well as smiling and laughing help.Smile as often as possible! You need to smile a lot. Smiling is a sign of self-sufficiency. When you smile, your brain automatically adds happiness hormones. You cannot close and hide from the world around you. You need to share your feelings with loved ones, or talk to a psychologist, with women who are also pregnant. It is necessary to formulate your thoughts in a positive way, to focus your attention on positive feelings. In a pregnant woman, the unconscious is as open as possible for the perception of any information.Both received from outside, and arisen during the period of reflection or conversation. The famous American linguist B. Wharf, the founder of the theory of “linguistic relativity”, argued that how a person speaks, so he lives. We must try to teach ourselves to express thoughts and pronounce them differently, to replace negative language clichés, that is, programs, with positive ones. In this case, it is necessary to analyze your thoughts, statements, reflections, the style of your speech turns. Try to make more positive statements, which in turn will develop into an emotionally favorable aura.

One of the main points for a favorable course of pregnancy is communication with your baby, the father of the child. During pregnancy, new good family relationships are created, or vice versa, misunderstandings are created. For a woman, the most important thing is help from a loved one. But a man also has difficulties during his wife’s pregnancy. It is not easy for him to realize that a man is growing inside you. The man is also worried about the changes that have occurred in your body, and in the family in general.

Few men are happy to chat with a child or enjoy when he pushes. This is not proof that a man is indifferent. He experiences the state of pregnancy in a special way. A woman should educate him about pregnancy. He needs to get information about what is happening. You should visit the doctor together, and go for an ultrasound together. Many men, when they see a child through a screen, completely change their attitude, as if they were convinced that the child really exists.

It is necessary to pronounce the word “We”, this is an additional factor of the fact that you are not alone. Tell your husband how you feel. If, in the beginning, you do not achieve what you want, do not be discouraged and do not blame your husband for not understanding you. Most men do not know how to show their feelings. To get closer, the husband can participate during childbirth. He can hold your hand, remind you how to breathe. Participation in childbirth will help him understand that he is already a father.

Do not forget that you carry the whole world inside you for the baby, the more you are filled with positive feelings, the better your child develops.Communication with a baby makes a woman’s life richer, helps to look at life differently, creates new feelings and sensations. In your thoughts, talk to your child more often, tell him your emotions and thoughts. Imagine more often that you will have a healthy, strong and beautiful child, such thoughts are well reflected in the development of the baby.

Head of the women’s department, psychiatrist E. N. Piorova

The material was prepared on the basis of a review of Internet articles from www.zabolevaniya.ru

90,000 Pregnancy Questions and Answers – Useful Articles

What to expect? How to eat? How to deal with difficulties? How to get it right? These and many questions will be answered by Irina Aleksandrovna Soleeva, an obstetrician-gynecologist at the Sadko clinic.

– How is the due date calculated?

From the first day of the last menstrual period. To determine the due date, 280 days are added to the first day of the last menstruation, i.e.e. 10 obstetric, or 9 calendar, months.

Usually, the calculation of the term of birth is made easier: from the date of the first day of the last menstruation, 3 calendar months are counted back and 7 days are added. So, if the last menstruation began on October 2, then, counting back 3 months (September 2, August 2 and July 2) and adding 7 days, determine the expected date of birth – July 9; if the last menstruation began on May 20, then the expected due date is February 27, etc.

The estimated due date can be calculated by ovulation: from the first day of the expected, but not coming menstruation, 14-16 days are counted back and 273-274 days are added to the found date.

– And if you know exactly the date of conception, then how many days to add?

A large-scale study was carried out with a large number of pregnant women, according to various indicators, the gestational age and, accordingly, the date of birth were determined. It turned out that a woman most often remembers the date of her last menstrual period. And from this fixed date, as the study showed, childbirth occurs at the 40th week ± a couple of weeks. Obstetricians-gynecologists are guided precisely by this calculation system.

– Is it worth changing your diet, if so, how?

In the first half of pregnancy, 4 meals a day are recommended, in the second – 5-6 meals a day. It is better to eat often, but little by little. For healthy women, there are no prohibited foods (except for alcoholic beverages), there are only more or less preferred ones.

So, the body better assimilates easily digestible milk fats and vegetable oils. The latter are not only a source of essential linoleic acid, but also vitamin E, which has a positive effect on the course of pregnancy.

To eliminate constipation, it is worth enriching the diet with sources of dietary fiber (fiber, pectins) – vegetables and fruits, buckwheat and oat groats.

In the second half of pregnancy, sugar, confectionery and flour products, rice should preferably be eaten in very small quantities. Do not get carried away with fried, spicy, salty foods, because during this period, the liver and kidneys of the pregnant woman function with tension. It is better to prefer boiled and steamed dishes.

The main thing is to include a variety of foods in your diet: vegetables, fruits, juices – and you will provide yourself and your unborn child with everything you need for normal development.

– I really want olives, but they are canned. Can?

It depends on the gestational age. After 20 weeks, I would not recommend eating too salty food, including olives. Anyway, any canned food is not the most suitable food for a pregnant woman. Although olives, by themselves, are a very healthy product. Therefore, within reasonable limits, say, you can eat a jar in two days.

– And the grapes?

The grapes are very digestible.This is fructose. It is immediately absorbed and rapidly raises blood sugar. But if you are overweight, it is either not recommended at all, or allowed in small quantities. It is allowed to eat a small brush, or you can treat yourself to something else.

For some reason, it is generally accepted in our country that if you are pregnant, you have to eat for three or whatever you want. As a result, pregnant women buy grapes in boxes and eat them in kilograms. Such a diet does not lead to anything good: sugar appears in the urine, blood sugar rises, babies are born large.Moreover, a big load falls not only on the pancreas of the mother, but also on the pancreas of the child – the baby from birth will be predisposed to excess weight.

– Can you lose weight during pregnancy and cleanse your body with special teas?

All cleansing teas are contraindicated during pregnancy. We have drugs that improve liver and kidney function and have a diuretic effect. We assign everything individually.No special cleansing procedures are performed during pregnancy. However, we have fasting days – here’s the best cleansing procedure for you.

– What vitamins are better for choosing during pregnancy?

Now there is a huge selection of various vitamin complexes for pregnant women. Of course, they are all close to each other in composition. One or two components or the dosage of a certain vitamin differ. In order not to harm herself and the baby, to achieve the maximum effect, each patient needs to select vitamins, relying on the advice of her doctor, who monitors the course of pregnancy.

– How long to take them?

Multivitamin preparations cannot be taken continuously. The necessary course can only be selected by a doctor, taking into account the condition of your body. We have different periods when it is better to stop taking vitamins altogether. In certain weather seasons, when there is enough sun, fresh vegetables and fruits, there is no need to take vitamin complexes.

– Is it possible to continue playing sports?

Not only possible, but also necessary.From the first months of pregnancy. They will help to keep in good physical shape, and this will definitely help during childbirth, relieve excessive tension and improve mood. The main thing to remember is that the training program should be specially adapted for pregnant women and should be carried out under the supervision of a doctor or an experienced instructor.

– Should you really push yourself into childbirth classes? Will diligence create the danger of premature birth?

No, there is no danger in this exercise.If there is anything to beware of, it is cycling, horse riding, roller skating – all sports with an increased risk of injury.

– Can I take a contrast shower?

You can. If a woman has used this procedure before pregnancy. But during pregnancy, the water should not be too hot. By the way, hot baths and baths should also be excluded.

– Can I continue to have sex during pregnancy?

Each couple decides for themselves.If both are pleased, if the woman is comfortable, then you can maintain a sex life almost until childbirth. Of course, too active sex will have to be ruled out, and two or three weeks before childbirth, and stopped altogether: too vigorous sexual intercourse: can provoke premature birth.

If earlier it was very strict: from 30-32 weeks sexual activity stops, but now sex life is excluded by the doctor only if there are any abnormalities. After a while, he can allow to resume intimacy.There are cases when sexual activity is excluded for the entire 40 weeks.

– Do I need to use contraception during pregnancy in order not to get pregnant again?

Very funny question. If one pregnancy has already occurred, re-conception cannot occur during this period. The need for protection is therefore eliminated.

– Can I sleep on my stomach?

On short terms, you can. The uterus leaves the pelvic cavity after 12-13 weeks.Before that, it is protected by the pelvic bones, which means that we will not cause any harm to the fetus.

– So, the work of the future mother. Should you reconsider your working day taking into account the new state?

Working during pregnancy is perfectly acceptable if there are no abnormalities. It is important to remember that pregnant women should not lift weights, work in heat and in high humidity conditions. Avoid contact with harmful substances and prolonged standing.

– Can motorists continue to drive?

You can drive a car if there are no contraindications from the doctor who monitors you during pregnancy. And it is not desirable at a later date after 30 weeks, because there is a very strong load on the pelvic floor muscles, legs and arms work, concentration of attention is required – this is an additional stressful situation for your body. And of course, do not neglect the seat belt.It will not over tighten your belly, but will pass obliquely under it and under the arm.

– How to deal with the signs of varicose veins?

It depends on the degree of varicose veins, its severity. Despite the rich selection of various preparations of internal and local action – tablets, drops, ointments – the most effective method of struggle is, nevertheless, wearing compression underwear. By the way, those who spend most of their working time sitting at the table, or on the contrary, standing on their feet, should also think about the prevention of varicose veins.

It is better to stop your choice on pantyhose: a golf elastic band or a stocking squeezes the leg too much, and when bandaging your legs, it is difficult to determine the necessary compression.

Pantyhose should be picked up by a doctor. A phlebologist works in our clinic. He will be able to select the required compression ratio.

Do not be afraid that the underwear will tighten both legs and stomach too much: there are special tights for pregnant women. A special insert on the stomach hugs him, supporting him without squeezing at all.

– How to be smokers: will it provoke them to quit the bad habit of stress for the body, if the smoking experience before pregnancy was quite long?

Smoking during pregnancy is very bad. This applies equally to active and passive smokers. The fetus develops chronic hypoxia – a constant lack of oxygen. And it primarily affects the development of brain structures. The consequence is deviations from the norm in mental development.Even if the violations are minor at first, in infancy, they are likely to manifest themselves in kindergarten or school, when the maximum load falls on the child’s intellect. It will be difficult for the kid to learn, to perceive some information.

Moreover, the threat of premature birth and miscarriages at different stages of pregnancy is growing. Children are often born small.

Stories that quitting habitual smoking will become severe stress for the body are far from the truth. Our patients awaiting the arrival of the baby give up this bad habit without much difficulty.Even if you regularly inhaled tobacco smoke both before and after conception, you should not think that it is still too late to quit. The harm you will inflict on your baby if you continue to smoke is not comparable to the unwillingness to part with the cigarette.

– Where and how to find a qualified doctor who can be trusted to take care of yourself and your future child?

The Women’s Health Center of the SADCO Clinic gathered the best specialists of the city: obstetricians-gynecologists, mammologists, ultrasound doctors, therapists, psychologists, exercise therapy doctors.The modern equipment of gynecology allows you to accurately and quickly carry out all the necessary diagnostics, and, if necessary, treatment. The advantages of such an integrated approach are obvious: you don’t have to go far, but the main thing is that you are served by one team, one hands. We will be happy to help both expectant mothers and those who really want to become them.

90,000 Pregnancy in women with Rh negative blood

The issue of Rh-conflict during pregnancy is one of the few in medicine, in which all the i’s are dotted and not only diagnostic and treatment methods have been developed, but also, most importantly, effective prevention.

The history of Rh-conflict immunization is a rare example of unconditional success in medicine. Indeed, after the introduction of a complex of preventive measures, infant mortality from complications of the Rh-conflict decreased from 46 to 1.6 per 100 thousand children – that is, almost 30 times.

What is Rh-conflict, why does it arise and what to do to minimize the risk of its occurrence?

The entire population of the planet, depending on the presence or absence of the protein denoted by the letter “D” on erythrocytes (red blood cells), is divided into Rh-positive and Rh-negative people, respectively.According to rough estimates, Rh-negative Europeans are about 15%. When a Rh-negative woman becomes pregnant from a Rh-positive man, the probability of having a Rh-positive child is 60%.

In this case, when fetal red blood cells enter the mother’s bloodstream, an immune reaction occurs, as a result of which the fetal red blood cells are damaged, anemia and a number of other serious complications develop.

During physiological pregnancy, fetal erythrocytes cross the placenta in the first trimester in 3% of women, in the second – in 15%, in the third – in 48%.In addition, massive abandonment occurs during childbirth, after termination of pregnancy (abortion, miscarriage, ectopic pregnancy, cystic drift), invasive procedures (chorionic villus sampling, amniocentesis), prenatal bleeding with the threat of termination of pregnancy.

The total risk of developing Rh-conflict in Rh-negative women who are pregnant with Rh-positive fetuses in the absence of prophylaxis is about 16%. In women who have undergone prophylaxis, this risk is reduced to 0.2%.

And now the most interesting thing – what exactly is this prevention and what needs to be done to keep the situation under control.

All women who applied to a medical institution for registration for pregnancy, as well as those who applied to terminate an unwanted pregnancy, are assigned an analysis to determine the blood group and Rh factor. Sexual partners of women who have a negative Rh are also recommended to undergo an examination to establish Rh affiliation.If, by a happy coincidence, a man also has a negative Rh factor, then there is no risk of a Rh conflict and there is no point in carrying out immunoprophylaxis.

Women with Rh-negative blood and Rh-positive blood belonging to a partner who wish to terminate an unwanted pregnancy are advised to inject an anti-Rh immunoglobulin within 72 hours after the termination. The mechanism of action of this drug is based on the fact that the injected antibodies bind fetal erythrocytes that have entered the maternal bloodstream and prevent the development of an immune response.

Rh-negative women who are registered for pregnancy are prescribed a monthly blood test for anti-Rhesus antibodies. Thus, it is determined whether there was contact between the blood of the mother and the fetus, and whether the woman’s immune system reacted to a foreign protein.

If by the 28th week there are no anti-Rhesus antibodies in the woman’s blood, she is sent for prophylactic administration of anti-Rhesus immunoglobulin. This prophylaxis is carried out from 28 to 30 weeks of pregnancy.After that, the determination of anti-rhesus antibodies in the mother’s blood is not carried out.

If, according to the results of the examination, anti-Rh antibodies are detected in a woman before 28 weeks of pregnancy, she is sent for an in-depth examination to determine the severity of the Rh-conflict, the timely appointment of treatment and, if necessary, emergency delivery.

After the birth of a Rh-negative woman, the Rh factor is determined. And, if the baby is Rh-positive, within 72 hours after giving birth, the woman is also injected with anti-Rh immunoglobulin.

Other situations requiring prophylactic administration of anti-rhesus immunoglobulin:
  1. spontaneous miscarriage or miscarriage;
  2. ectopic pregnancy;
  3. gallbladder drift;
  4. prenatal haemorrhage with threatened termination of pregnancy;
  5. Invasive intrauterine interventions during pregnancy.

The only controversial issue at the moment is the determination of the Rh factor of the fetus during pregnancy.For this, starting from 10 weeks of pregnancy, a woman’s blood is taken, the genetic material of the fetus is isolated from it, and on the basis of genetic research, the Rh-belonging of the unborn child is determined.

On the one hand, this study would have allowed 40% of Rh-negative women carrying Rh-negative fetuses to avoid monthly anti-Rh antibody testing and anti-Rh immunoglobulin administration.

On the other hand, this study does not appear in the official order of the Ministry of Health, is not included in the CHI system and is carried out only on a paid basis.

Thus, at the moment, a clear algorithm has been developed for the management of pregnant women with Rh-negative blood. And following this simple algorithm will allow a woman to give birth to one, two or more healthy babies.

Obstetrician-gynecologist
antenatal clinic №14
Khivrich Ye.B.

Health Committee of St. Petersburg | News

How can a pregnant woman protect herself from COVID-19?

05 June 2021

In the context of the pandemic, it became necessary to protect pregnant women, who were more frightened than others.After all, they are responsible for at least two lives at once. We asked Mikhail Dmitrievich Zlokazov, an epidemiologist at Maternity Hospital No. 10, to share with universal advice.

In a pandemic, doctors and scientists are concerned about the risk of complications after a coronavirus infection for both a child and a woman. In an extensive foreign study, combining materials from 39 sources, experts analyzed over 1,300 pregnancy histories of patients hospitalized with moderate and severe forms of new coronavirus infection.45% of these women gave birth> 37 weeks. Preeclampsia was registered in 6%, while the miscarriage rate was 14.5% [4].

The number of caesarean sections has increased dramatically. In the materials of foreign researchers, it was also noted that only a third of pregnant women with moderate and severe forms of coronavirus infection were delivered through the vaginal birth canal [4].

Some sources claim that the risk of developing infectious complications in pregnant women is at the same level as in other population groups.It is important to understand that pneumonia and other complications during pregnancy are dangerous for the health and life of both women and children [4,6].

Children often had cases of fetal distress – a complication in childbirth associated with a lack of oxygen (26.5% of cases), while neonatal asphyxia was noted in less than 1.5% of children. Doctors have noticed that the deterioration of the condition of the newborn is more often manifested by respiratory disorders, intrauterine growth retardation, abnormal development of the respiratory, nervous and immune systems [3,5].Such complications are usually a consequence of the effect of COVID-19 on the mother’s body. At the same time, at the moment there is no convincing reason to believe that coronavirus infection can be transmitted in utero from mother to fetus [1,4].

Analyzing the data obtained, we can conclude that the severe course of coronavirus infection worsens the prognosis of pregnancy for both the mother and the child. Whereas a mild and asymptomatic course of the disease, with a high probability, will not affect the outcome of childbirth and the condition of the newborn.Such information convinces us that it is extremely important to comply with measures to prevent the infection of expectant mothers with a new coronavirus infection.

The first recommendation – regardless of the gestational age – to exclude contact with sick people and those who may be a source of infection. If possible, self-isolate. You need to take a walk in the fresh air, but it is better away from people. It is also not worth giving up routine doctor’s consultations. On the contrary, control over the condition of the fetus is necessary.But, if symptoms of a viral infection appear, the planned visit to the antenatal clinic should be postponed and a doctor’s therapist from the polyclinic should be called to the house.

A pregnant woman should eat properly, adhere to a balanced diet, and be physically active. Breathing exercises will be of great benefit. This recommendation is suitable for everyone, because it is easier for working lungs to “get rid” of viruses, but it is especially relevant for pregnant women. Pregnancy in itself impairs the circulation in the woman’s lungs, because of the growing uterus, they shrink and work less.In addition, the ability to breathe actively and correctly is very useful in childbirth. That is why, in our courses at the Childbirth Preparation Center, a special emphasis has recently been placed on breathing exercises.

It is important to remember about the rules of hygiene [2] :

* Wash your hands regularly and thoroughly with soap and water;

* Use an alcohol-based hand sanitizer;

* Cover your mouth and nose with disposable tissues when sneezing and coughing;

* Do not touch your face, mouth, nose and eyes with your hands;

* Regularly perform wet cleaning at home and ventilate the room;

* Avoid crowded places and public transport;

* Keep in touch with friends and family via phone, Internet and other means of communication available to you.

These simple rules are relevant not only for a pregnant woman, but also for her family members. Anyone entering a home should follow standard hygiene precautions, including hand washing and changing from street clothes to home clothes.

Pregnancy is a contraindication to being vaccinated against coronavirus, but the woman’s environment – her husband, parents, those with whom the expectant mother lives or often contacts can protect her by vaccinating herself, as the staff of Maternity Hospital No. 10 has already done.After all, the likelihood of contracting covid while communicating with vaccinated people is reduced to zero for a pregnant woman.

For the successful course of pregnancy and childbirth, the psychological state plays an important role. Therefore, you should not fall into a panic mood and bring the situation to the point of absurdity. All measures taken should protect the expectant mother, and not bring discomfort. And of course, there is nothing more useful for a pregnant woman than the care and support of family and friends.

Materials used to write this article:

  1. Goncharova, M.A. New coronavirus infection SARS-COV-2: impact on pregnancy / M. A. Goncharova, Yu. A. Petrov // Chief Physician of the South of Russia. – 2020. – No. 4 (74). – S. 27-31.
  2. Materials from the site: http://cgon.rospotrebnadzor.ru/content/63/4141/
  3. Sinchikhin, S.P. New coronavirus infection and other respiratory viral diseases in pregnant women: a clinical lecture / S.P. Sinchikhin, L.V. Stepanyan, O.B. Mamiev // Gynecology. – 2020. – T. 22. – No. 2. – C. 6-16.
  4. Diriba, K.The effect of coronavirus infection (SARS-CoV-2, MERS-CoV, and SARS-CoV) during pregnancy and the possibility of vertical maternal – fetal transmission: a systematic review and meta-analysis // K. Diriba, E. Awulachew, E. Getu // European Journal of Medical Research 25. –2020, – Vol. 39 Available from: https://doi.org/10.1186/s40001-020-00439-w
  5. Potential effects of SARS-CoV-2 infection during pregnancy on fetuses and newborns are worthy of attention // D. Dang [at al.] // J Obstet Gynaecol Res.–2020, – Vol. 46 (10). – P. 7
  6. Pregnancy and Neonatal Outcomes in SARS-CoV-2 Infection: A Systematic Review // R.S. Chamseddine [at al.] // Journal of Pregnancy. –2020, – Vol. 2020. – P. 7 Available from: https://doi.org/10.1155/2020/4592450

90,000 Normal pregnancy in women can vary within five weeks

Scientists have questioned the seemingly unshakable fact – the baby develops in the womb for nine months. They just calculated the deadlines accurately and received a lot of interesting information.

The duration of a woman’s pregnancy – it would seem, what could be new here? Of course, the well-known nine months is very rounded. Doctors calculate how long a baby is expected to be born by counting 280 days from the start of the last menstrual period.

But, according to statistics, only 4% of women give birth in the prescribed 280 days, and 70% fit within plus or minus ten days from the appointed date.

An unexpected conclusion was made by specialists of the National Institute for the Study of Health and the Environment in Durham, USA.They proved that the duration of a normal pregnancy can vary very widely – with a range of 37 days, and reported their results in the journal Human Reproduction .

The timing of such important processes as ovulation (release of a mature egg from the ovary) and implantation of an embryo into the uterus has been estimated so far very roughly.So, doctors determine the moment of ovulation by the rise in the morning rectal temperature. But this method carries with it a big error and, moreover, does not say anything about when the embryo entered the uterine lining.

The essence of the approach that was used in this study, in the accuracy of determining the moment of conception.

The team used information from 130 women who had previously participated in a pregnancy study in North Carolina. During the study, urine samples were collected from women daily and tested for hormone levels.Changed hCG (chorionic gonadotropin), estrone-3-glucuronide and pregnanediol-3-glucuronide. The day of ovulation was determined by the drop in the ratio between estrogen and progesterone. And the moment of implantation of the embryo into the uterus was defined as the first day of the rise in the hCG level.

Experts have analyzed the timing of childbirth in 125 women with normal pregnancies. And it turned out that the time from the moment of conception to the moment the child is born varies quite a lot.

“We have calculated that the average time from ovulation to childbirth is 268 days – 38 weeks and two days,” says Anna Maria Djukis, study author.“However, even when we ruled out six cases of preterm birth, we found that the duration of pregnancy varied within 37 days.”

Until now, it was believed that the variation in the duration of pregnancy is due to errors in determining its onset.Scientists have ruled out mistakes – and the spread has even increased. “This is amazing!” – says Djukis.

In addition to the inconstancy of the duration of pregnancy, scientists have found that the embryo, which takes longer to be introduced into the uterus after fertilization of the egg, develops longer. And if at the beginning of pregnancy there was a late rise in progesterone, the pregnancy was shorter than with an early rise, on average by 12 days. Experts were surprised by the fact that events occurring at the very beginning of pregnancy affect its outcome – at the time of the birth of the child.They conclude that by observing the onset of pregnancy, it is possible to predict its end to some extent.

Djukis and her colleagues analyzed a variety of factors that have been shown to be correlated with pregnancy duration.

In older women, pregnancies lasted longer, with each year of the woman’s age adding one day to her pregnancy.

And women, who themselves at birth had more weight, carried their child longer.Experts calculated that for every 100 grams of birth weight, the mother added one day to her pregnancy. Finally, if a woman’s previous pregnancies lasted longer than the average, then the subsequent pregnancy was also longer. The latter is regarded by experts as proof of the influence of a woman’s individuality on this indicator.

So, the authors of the study come to the conclusion that the duration of pregnancy in a woman can vary greatly and depends on many factors, even with an accurate determination of the moment of ovulation.They suggest that the “timecode” of pregnancy can be more or less accurately determined based on the hormonal events of the first two weeks after conception and the duration of previous pregnancies.

However, they believe that it is premature to make any clinical recommendations based on the results obtained. This will require more research. But doctors at least need to be aware that it is normal to deviate from the expected due date of five weeks.

90,000 General information and advice for all pregnant women during the coronavirus

pandemic

Information for pregnant women and their families.

This information is not intended to meet your specific, individual health care needs. This information is not a clinical diagnostic of your health condition. If you are concerned about your health or general well-being, we strongly recommend that you contact your healthcare professional if necessary.

General information and advice for all pregnant women during the coronavirus pandemic.

Question: What is the effect of the coronavirus on pregnant women?

In general, pregnant women are not more likely to become seriously ill than other healthy adults if they are infected with the coronavirus. The vast majority of pregnant women are expected to experience only mild to moderate cold / flu symptoms. Cough, fever, shortness of breath, headache, and loss of smell are suspected symptoms of coronavirus infection.

The development of severe complications, such as pneumonia, is more common in the elderly, people with weakened immune systems, or those with long-term chronic illnesses. So far, there is no evidence that pregnant women who become infected with the coronavirus are at greater risk of developing serious complications than any other healthy person. Our advice remains the same: if you feel that your health is getting worse or you are not getting better, you should contact your obstetrician-gynecologist or antenatal clinic.

Q: What effect will the coronavirus have on my child if I am diagnosed with this infection?

Since this is a very new virus, we are just beginning to learn about it. There is no evidence to indicate an increased risk of miscarriage.

Emerging evidence suggests that transmission from a woman to her baby during pregnancy or childbirth (vertical transmission) is likely. There are two reported cases in which this seems likely, but it is encouraging that both children were discharged from the hospital and are healthy.In all previously reported cases worldwide, infection was detected at least 30 hours after birth. It is important to emphasize that in all reported cases of the development of coronavirus in newborns, the child was healthy after birth.

Given current evidence, it is considered unlikely that if you are infected with the coronavirus it will cause developmental problems for your child.

In China, some babies are born prematurely to women with coronavirus symptoms.However, it is unclear whether the coronavirus caused this premature birth, or whether the delivery was carried out earlier, according to a doctor’s decision, for the health benefits of women.

Q: What can I do to reduce my risk of contracting coronavirus?

The most important thing to do is to follow the general requirements. For pregnant women and the rest of their families, this includes:

regular hand washing;

Use a tissue when you or someone in your family coughs or sneezes, throw it away and wash your hands;

Avoid contact with those showing symptoms of coronavirus.These symptoms include high fever and / or cough;

avoid using public transport as much as possible;

work from home, if possible;

avoid going to public places, as the infection spreads easily in enclosed spaces;

Avoid meeting friends and family. Keep in touch using remote technologies such as phone, internet and social media;

use phone or online services to contact your doctor or other essential services.

Question: I am pregnant, what should I do?

As a precautionary measure, you should follow general medical advice on social distancing.

Stay out of public areas and avoid those with acute respiratory symptoms when going outside to shop for food, exercise, and attend antenatal clinics.

If you are in your third trimester of pregnancy (more than 28 weeks), you should be especially careful about social distancing and minimizing any contact with other people.

Question: Should I attend my antenatal and postnatal appointments at the antenatal clinic?

Yes. When you are healthy, it is really very important that you continue with your scheduled medical appointments.

If you have symptoms of a possible coronavirus infection, you should contact your doctor to postpone routine visits until the end of the isolation period.

If you are currently healthy and have not had any complications during previous pregnancies, then the following practical advice may be useful to you:

If in the coming days you have a planned examination or visit, please contact your antenatal clinic to receive and agree on a plan for your further observation.The dates of the visit are subject to change.

If you have been advised to attend an examination or make an appointment with an antenatal clinic, this is because the need for this appointment is greater than the risk of contracting the coronavirus. Antenatal care is essential to maintaining a healthy pregnancy, so we strongly recommend that you comply with the deadlines if you are asked to do so. If you have any doubts about this, please discuss them with your obstetrician-gynecologist.

Whatever your personal situation, please consider the following:

The Maternal and Child Health System is essential and has been developed over the years to reduce the likelihood of possible complications in women and children. The risk of refusing antenatal care includes harm to you, your baby, or both of you, also in the context of the coronavirus. It is very important that you keep in touch with your antenatal clinic and continue to attend scheduled check-ups when you are feeling well.If you have any concerns, please contact your Obstetrician-Gynecologist, but note that the medical staff is currently working with greater stress.

If you have symptoms of coronavirus, please contact your antenatal clinic and they will arrange the right place and time for your visits. You will be asked to go to the doctor’s appointment alone or to reduce the number of people with you to one. During this time, we ask that children not accompany you.

You may need to reduce your antenatal visits.Your obstetrician-gynecologist will tell you about this. We assure you that this change will be made as safely as possible, taking into account the available data on the safe number of visits required. Please do not shorten the number of visits without first consulting your doctor.

Question: What should I do if I have a fever or fever, or both, when I am pregnant?

If you have a fever or cough, or both, during pregnancy, you should contact your doctor for advice on isolation, which you must follow in accordance with current regulations.However, please also be alert for other possible causes of fever during pregnancy. In particular, these include infections of the bladder (cystitis) and other conditions. If you have any burning sensation or discomfort while urinating, or any unusual vaginal discharge, or have any concerns about your child’s movements, talk to your healthcare provider who can provide additional advice.

Question: What should I do if I think I may have coronavirus or have been exposed to it?

You should contact your antenatal clinic to inform them that you have symptoms suggestive of coronavirus, especially if you have a visit within the next 7 days.

Q: How will I get tested for coronavirus?

The process of diagnosing coronavirus infection is changing rapidly. If you really need to take the test, you will take it just like everyone else, regardless of the fact that you are pregnant.

Question: What if I test positive for coronavirus?

If your coronavirus test is positive, you should contact an antenatal clinic to inform them of your diagnosis.If you have no symptoms or mild symptoms, you will be advised to recover at home. If you have more severe symptoms, you may be referred to a hospital for treatment.

Question: Can I transmit coronavirus to my child?

Since this is a new virus, there is limited data on caring for women with coronavirus infection when they have just given birth. A small number of infants were diagnosed with the coronavirus shortly after birth, so there is a possibility that the infection could have occurred in the womb, but it is not yet known exactly when the infection occurred before or after birth.A medical team will maintain strict infection control measures during your labor and closely monitor your baby.

Question: Will my child be tested for coronavirus?

If you have confirmation or suspicion of a coronavirus at birth, doctors specializing in newborn care (neonatal doctors) will examine your baby and advise you on care, including whether it needs testing.

Question: Will I be able to breastfeed my baby if I have a suspicion or confirmation of the coronavirus?

Yes. There is no evidence that the virus can be carried or transmitted in breast milk. The recognized benefits of breastfeeding and the protection it provides to infants outweigh any potential risks of transmitting coronavirus through breast milk. Provided your baby is healthy and does not need neonatal care, you will stay together after birth.

The main risk of breastfeeding is close contact between you and your baby, as if you cough or sneeze, it may contain droplets that are contaminated with the virus, which leads to infection of the baby after birth.

A discussion of the risks and benefits of breastfeeding should be between you and your neonatologist.

When you or someone else is feeding your baby, the following precautions are recommended:

Wash your hands before touching your baby, breast pump or bottles;

try not to cough or sneeze on your baby while breastfeeding;

Consider wearing a mask while breastfeeding;

Follow the guidelines for cleaning your breast pump after each use;

If you decide to feed your baby with formula or expressed milk, it is recommended that you strictly adhere to the sterilization recommendations.If you are expressing breast milk in the hospital, a dedicated breast pump should be used.

Question: Is there an increased risk for me or my baby after childbirth?

There is no evidence that healthy women who have recently given birth are at increased risk of contracting the coronavirus. The immune system of a newly pregnant woman is considered normal if she does not have other forms of infection or underlying disease. You must eat well, do moderate exercise, and make sure social distancing is respected.Children, including newborns, do not appear to be at high risk of becoming seriously ill with the virus. However, good hygiene is essential for family members living in the home. Everyone entering a home should follow standard hygiene precautions, including hand-washing, and be careful when handling your child if they have symptoms of any illness, including coronavirus.

It is very important that your child is eating well and gaining weight, and if you have any concerns, please contact your doctor.

Do not delay seeking medical attention if you have concerns about your child’s health during a pandemic. See your doctor if your child has a fever, lethargy, irritability, poor appetite, or any other symptoms that may bother you.

90,000 Longest pregnancy in the world

Everyone knows that pregnancy lasts 9 months or 40 weeks. However, in world medicine, several cases have been recorded at once when pregnancy lasted much longer than the prescribed period.Read about the three most impressive cases below.

Pregnancy long in a year

An expectant mother from Los Angeles named Bela Hunter, instead of 9 months, was pregnant at once 12. The case was recorded in 1945. At first, the doctors did not want to believe the girl, but her chart indicated the dates of the menstrual cycle, her pregnancy actually lasted 375 days.

The baby decided to be born on his own, the help of doctors was not needed.It is noteworthy that the girl was born absolutely healthy and with a normal weight – 3100 g. The doctors concluded that the late birth was due to the slow development of the fetus. Obviously, the child did not receive the required amount of vitamins and nutrients, and therefore developed much more slowly than the term.

17 months gestation

In 2016, Wang Shi from the Chinese province entered the Guinness Book of Records, thanks to the fact that her pregnancy lasted as long as 17 months! The girl became pregnant in February 2015, and according to the doctors, the child was supposed to be born in November.However, the baby was not born in due time, after the examination, the doctors decided that he was underdeveloped and it was too early to do a cesarean, despite the gestational age of 14 months. All this time, doctors monitored the condition of the mother and baby, it was satisfactory, and as a result, the baby was born only 17 months after the start of pregnancy. The baby was absolutely healthy and weighed 3800 g.

By the way, in China, this pregnancy was discussed by doctors for a very long time, because not all experts believed Wang Shi, suspecting her of fraud.As a result, the study of the anamnesis showed that placenta previa most likely led to such a long pregnancy (with the placenta completely blocking the entrance to the cervix).

Half Life Pregnancy

However, the most unique case of long pregnancies was recorded in Morocco. Zahra Abutalib became pregnant in 1955 and was admitted to the hospital on time with drained waters. But an amazing situation happened there. Literally in front of the girl’s eyes, a woman in labor died of complications, Zahra was very scared and ran away from the hospital.Against the background of stress, her contractions even stopped.

Moroccans firmly believe that a child can stay in the womb for as long as they want (and this is even for the benefit of the mother, because in this way he preserves her honor). Zahra also believed in this legend and therefore did not rush to the hospital. As a result, her pregnancy lasted …. 46 years!

Over the years, the woman began to suffer from pulling pains in the abdomen, but she did not go to the doctors and endured the pain. As a result, only at the age of 75, the attacks became so severe that the woman still went to the hospital.An ultrasound scan found something similar to a human fetus in her fallopian tube. Doctors performed an emergency operation and removed the petrified body of the fetus from the fallopian tube (it looked more like a stone than a child).