While you know and understand that pregnancy will bring about changes to your body, you may not expect your breasts to change so dramatically or to be effected by your pregnancy to such an extent. You may be expecting changes closer to the end or after the birth, when your body will be getting ready for breastfeeding, but you may not be aware that your breasts will start changing as early as your first trimester.

Some women report tenderness and hypersensitivity so early, that this was the first clue to their pregnancy. Other women suspected they were pregnant due to a darkening of their nipples and areolas (the skin around the nipple.) This change in color is caused by hormones which effect the skin’s pigmentation. At the same time, many women notice these types of changes to their breasts much later in the pregnancy or not at all.

Other changes to your breasts, other than their growing size, may include the appearance of green or darkened veins (due to the larger volume of blood in your body during pregnancy.) You may find that your nipples are leaking. This clear/yellow thick liquid is called colostrums and is extremely nutritious for your baby. You may also notice that your nipples stick out more and/or the areolas and nipple areas are larger in size.

These changes are caused by hormonal changes due to the pregnancy and effect different women differently. To handle some of these changes better and avoid being uncomfortable, get a good supportive bra, with an adjustable closure and no underwire.  Do not get a nursing bra before you give birth, as you will not know your final cup size. It is better to wait with this purchase, until about a week after childbirth, when your milk comes in and your breast size has reached its maximum.

After childbirth, if you choose to nurse, you will experience more breast related changes including the difficulties and challenges of breastfeeding, as well as, the joys and satisfactions like giving your baby the best, most suitable nutrition. You should know and accept, now, that your breasts will most likely NEVER return to their original shape. Who said being a mother is easy?

You had your baby and are not in any rush to get pregnant again. If you are nursing, you may have heard that you cannot get pregnant while breastfeeding. While interesting, this theory is not true. Some people believe it to be the case, possibly because many women do not have a menstrual period while nursing, but still, breastfeeding is NOT a method of birth control.

What are your options? This depends on your situation and needs. Consider whether you are concerned about sexually transmitted diseases or just want to prevent a pregnancy. This will narrow down the options you have and help you make the best choice. Also, speaking with your healthcare provider will help you to learn about your options and select the ones most suitable to your needs.

Barrier methods physically prevent semen from reaching the egg and must be used every time you have sex. They include diaphragm, cervical cap, contraceptive sponges and condoms.

You can be fitted for a diaphragm or a cervical cap at your 6 week postpartum visit, by your doctor. You will need to be fitted even if you have used one before, since after your pregnancy and childbirth you may need a different size.

Hormonal methods, such as birth control pills prevent a pregnancy by suppressing ovulation. The pill may have side effects (including nausea, headaches, acne, increased blood pressure, breast tenderness, bloating, weight gain and depression) – so you will have to have your doctor prescribe the most suitable kind for you. If you are breastfeeding you will be prescribed a pill that may cause you to not have your menstrual period until you stop taking it or switch to a different kind. Those pills are taken nonstop, different from the regular pill you take for three weeks and then have a week off, during your period.

The patch uses estrogen and progestin to prevent pregnancy and can be applied on the buttocks, abdomen, upper torso or outer arm. It is used for a 4 week cycle and each patch lasts for 1 week. You use 3 patches, one for each week, and no patch for the week during which you have your menstrual period. The patch has side effects similar to the pill.

The vaginal contraceptive ring is a thin, flexible ring that is inserted into the vagina. It releases hormones that prevent pregnancy. These hormones are the same ones used in most birth control pills. The ring is left in the vagina for 3 weeks. You will remove the ring after 3 weeks and your period will start. After 7 days, you will insert a new ring.

Hormone shots work much like the pill to prevent pregnancy, but also may have some side effects, such as headaches and changes in your period, mood and weight. There is a shot that prevents pregnancy for 1 month and another that lasts for 3 months.

Sterilization is another way to go. This is when a man or a woman has an operation to permanently prevent pregnancy. If you decide you do not want to have any more children, sterilization may be the right choice for you.

Tubal ligation, or “getting your tubes tied”, involves closing off a woman’s fallopian tubes so eggs can no longer travel through them to reach the uterus. A device called Essure can also be used to close off a woman’s fallopian tubes. Essure is a metal coil that is inserted into your fallopian tubes by your doctor.

Men are sterilized with a vasectomy. The man’s sperm ducts are closed off so sperm cannot get through.

Speak to your healthcare provider about all the options and which is most suitable for you. Do not take a chance with ‘withdrawal’ or safe-days; these are not effective methods to avoid becoming pregnant.

Amniocentesis is a prenatal test in which the amniotic fluid is analyzed for signs of birth defects or other problems. It is usually performed in women over 35 years of age or after an abnormal triple test result. Amniocentesis will also be suggested to you if there are inherited or genetic concerns in your family.

This procedure is elective, although may be recommended by your doctor, and is performed on an outpatient basis. An ultrasound is used to determine a safe location for the needle to enter the amniotic sac and amniotic fluid is collected. The procedure, in its entirety, can last about 45 minutes, though the actual collection of fluid takes less than five minutes. The amniotic fluid, which contains cells shed by the fetus, is sent to the laboratory for analysis. Results take anywhere from a few days to a couple weeks to be returned.

Amniocentesis is usually performed between weeks 14 and 20. It can also be conducted later, in the third trimester, if your membranes have ruptured prematurely, to assess for uterine infections, to determine the severity of fetal anemia in babies with Rh disease and to assist your physician in determining whether the fetus requires lifesaving blood transfusions.

Although the procedure is considered to be a safe, it is categorized as an invasive diagnostic test that poses potential risks. Miscarriage is the number one risk associated with amniocentesis. This risk ranges from 1 in 400 to 1 in 200. A miscarriage can occur due to an infection in the uterus, your water breaking or labor being induced prematurely. Although extremely rare, the possibility of the needle coming in contact with the baby does exist. The use of a sonogram is used to ensure the needle is inserted away from the baby.

You may experience a sharp pain when the needle enters the skin and again when it enters the uterus. After the procedure, you may experience other side effects which include: cramping, fluid leakage and/or minor irritation around the puncture site. Contact your healthcare provider if these complications continue or worsen.

While pregnancy is a time of excitement and anticipation, it can sometimes also be filled with unknowns, worries and concerns. While pregnant, you are more aware of your body as you follow the changes it is going through.  If this is your first pregnancy, you may be wondering how you will know when labor has begun. You may also wonder what, of all the new symptoms you are experiencing, is normal. You may wonder how your baby is developing, is he doing well or is there a reason to be concerned.

A healthy, low risk pregnancy lasts about 40 weeks. If you go into labor after the 37^th week, it is considered a full term pregnancy and there is no reason to be alarmed. However, if you go into labor before the 37 week mark, it is considered a preterm labor.  A baby born before 37 weeks of pregnancy is considered premature and can be at risk with regard to health problems.

Preterm labor is usually common in pregnancies with multiples, women with previous premature birth experience and women with certain uterine or cervical abnormalities.

Warning signs that you may be experiencing premature labor include 6 or more contractions an hour, leakage from your vagina indicating your water broke, cramps in your lower abdomen, back pain that comes and goes, pelvic pressure and/or an increase in vaginal discharge.

If you think you may be experiencing preterm labor call your healthcare provider immediately. To help prevent preterm labor, take these precautionary actions – lie on your left side, avoid lying on your back (it can cause contractions to increase), empty your bladder, drink plenty of water (dehydration can cause contractions) and count your contractions per hour.

If symptoms continue or worsen, go to triage. At the hospital you will be checked for the frequency of the contractions and your cervix will be examined to see if it is dilated. If your cervix is opening premature labor could be starting.

To stop or prevent premature labor, magnesium sulfate is given, via IV, at the hospital. If birth is unavoidable or seems to be near, corticosteroid is given to help mature the baby’s lungs and brain. While it is usually better for the baby to stay in the womb longer, birth is sometimes unavoidable. In these cases the baby may be admitted to the NICU (neonatal intensive care unit) for special care.

When there are complications with your pregnancy, you will be told by your healthcare provider to spend most or all of your time lying down. Around one in five women in the US is put on bed rest at some point during her pregnancy, for a few days to a few months, to prevent possible complications. Depending on your condition and its severity, your bed rest may vary from simply resting at home to full bed rest at the hospital with monitoring.

The reasons for bed rest include:

• Preterm labor
• Multiples pregnancy
• High blood pressure, preeclampsia and eclampsia
• Cervical changes including cervical effacement and incompetent cervix
• Vaginal bleeding
• History of pregnancy loss, stillbirth, or premature birth
• Poor fetal development
• Gestational diabetes
• Placenta complications, such as placental abruption, placenta previa, and placenta accreta

The purpose of bed rest is to help your body rest and minimize or overcome the condition that had your doctor put you on bed rest in the first place. If you suffer from high blood pressure, bed rest is used to decrease stress and lower blood pressure. Working, staying active or exercising may provoke or worsen certain situations. Bed rest is necessary to prevent or diminish certain conditions.

It is important to get a clear understanding of what your bed rest restrictions are. Depending on the nature and severity of your condition, the list of your approved activities may vary. If your doctor has not specified what you are allowed to do, make sure to ask about activities such as cooking, light housekeeping, walking, bathing or showering, driving, exercising and sexual intercourse.

While it may sound like resting is a great idea, especially now that you are exhausted because of your pregnancy and may need the rest anyway, you could find it less pleasant than expected. Being restricted to bed for days or even weeks or months can be boring, uncomfortable and inconvenient. However, do not take it lightly. Bed rest is prescribed for your health and your baby’s health.

Braxton Hicks, also referred to as false labor or practice contractions, is usually a painless tightening or hardening of your belly. It may be quite uncomfortable, but is your uterus’s way of preparing for true labor. Braxton Hicks contractions may cause thinning and dilating of your cervix. They usually first appears during the second trimester, around 20 weeks, though they may come earlier (and be more intense) if this is not your first pregnancy.

As your pregnancy progresses they may become more frequent, but before the last month of your pregnancy they are likely to remain irregular and somewhat painless. If you are not sure if you are experiencing Braxton Hicks contractions (false contractions) or true ones, which may be hard for you to determine especially if this is your first pregnancy, call your healthcare provider and ask to be seen and evaluated. Playing it safe and going to get checked out is always better than misdiagnosing your condition, yourself.

If you are less than 37 weeks pregnant and are experiencing more than four contractions an hour, call your healthcare provider immediately. After 37 weeks you may experience more intense and frequent contractions, which may also cause discomfort. These contractions are likely to be true ones, which also help your cervix ripen, by gradually leading to its softening and thinning out, and maybe even dilation.

Braxton Hicks are different from true contractions in that they do not grow longer, stronger and closer together like true ones do. They may trick you into thinking you are in labor, for they may feel frequent and painful. If you are not sure whether you are experiencing true or false labor, call your healthcare provider and get checked. You will likely be connected to a monitor at triage to determine your condition.

To overcome Braxton Hicks contraction discomfort:

• Change your position or activity – true contractions will persist regardless of what you try.
• Draw a warm bath to let your body relax.
• Drink plenty of water.
• Try breathing techniques from your birth preparation classes.

If you are the baby shower planner, you must know the expecting mother pretty well. Still, it is always a good idea to ask her what she does and does not want for her event. You may be surprised to learn about her thoughts in regard to her shower.

Before sending out invitations, ask the expecting couple when the best time is for them! We would not want the guest of honor to have a scheduling conflict. Other important participants to ask in advance are the grandparents-to-be. Another factor to take into consideration is timing relative to the due date – having the shower when the mother-to-be is already sporting a belly, but not too close to the due date, so she is comfortable and can enjoy her own party, is important.

When planning the party, it is always best to ask the guest of honor who should be on the guest list. You do not want to make assumptions or miss an important guest, accidentally.

Surprise baby showers can be a great deal of fun, but before you go ahead with such a surprise make sure the expecting mother likes these sorts of surprises. If you think there is a chance that she may not like this, it is best to not throw one so nobody is uncomfortable.

During the party, make sure the expecting mother is comfortable. A comfortable chair and a controlled temperature can make a big difference in her comfort level! An uncomfortable pregnant woman will be miserable and have a hard time enjoying herself.

When putting together the menu think of the mother to be. Large portions are not suitable for her now. If she suffers from heartburn you may want to ask what she can and cannot eat, spicy foods may be unsuitable for her, as well, or if she has gestational diabetes sweets may be inappropriate.

Before planning the activities for the baby shower, consider what the mother to be would like. Will traditional shower games be most appropriate or maybe a less traditional theme is more suitable. If you are not sure, ask her what she would like. She may want to be involved and share some of her own ideas.

One main event at baby showers is gift opening. To help out the guests, as well as make sure the expecting mother is getting what she really wants, take her to the store and help her start a baby registry. She may also start one online, if she prefers. This way everyone will be happy.