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.

You may think this would be easier, after all, you have been through it before and know all there is to know. Well, that’s not quite right. You may be surprised to find out that your second pregnancy will be different than your first and that you still have new experiences coming your way.

First you should recognize that each pregnancy is unique, even for the same woman; just like every child is unique and has his own personality, within the same family. Each fetus grows at his own pace and starts to develop his own persona from within. This may mean that one pregnancy will feel more active, kicking-wise, than the other and/or your body will respond differently.

The second time around you may find that you are more tired. Don’t forget that during your first pregnancy you had no one, but yourself to care for. Remember that time when you could rest as much as you wanted?  No such luck this time… you are now a mother and your little one(s) depends on you. Running after your child(ren) can be exhausting, especially now that you are pregnant.

It seems that since your body has already experienced changing and adjusting, to accommodate for a pregnancy, it would know what to do, but it can still surprise you with each new pregnancy. It really depends on how fit you were going into each pregnancy, how much time passed between pregnancies and if you are having multiples or experiencing a high risk pregnancy. Any difference in the circumstances can affect how your body will handle it this time around.

Try to set aside time to rest, our body needs it. Make sure you eat right, both you and your baby’s development depends on it. Personal time is important for you to recharge, being a mother and being pregnant only means it is harder to make the time, but not that it is no longer needed.

When you are pregnant your body and mind work somewhat differently than when you are not. Your mind may be occupied with the health and development of the baby, life changes to come after childbirth or fears of the unknown. Your body is also busy, growing your little one and providing for his development, which takes a lot of energy and nutrients from your body.

One of the changes in your daily routine caused by pregnancy is usually manifested at night, when you are laying down and ready for a much needed good night’s sleep. You will find that throughout your pregnancy sleep becomes harder and rarer. Maybe it is nature, designed to prepare us for sleepless nights after the birth, but the fact is, when you need it most, sleep becomes harder to get.

Night time urination is usually the first cause of sleepless nights during pregnancy. Next are the dreams, which may be caused by fears, concerns and other thoughts that come with becoming a parent.  Veteran moms also report strange dreams during pregnancy, so you are not free of these in subsequent pregnancies.

As the pregnancy progresses, and your weight and belly grow, you will find that you cannot sleep on your back or belly comfortably anymore. It is also suggested that you completely refrain from sleeping on your back after the 20^th week.

Some woman suffer from hip pain, and wake up repeatedly due to it, or experience pain when rolling over, which can be challenging to do. Further along in your pregnancy you may find it hard to get out of bed at all and may need to devise strategies to get yourself up. Funny as it may sound it is not pleasant and may be frustrating, at times. But you can find comfort in the fact that it is all temporary (until the next pregnancy) and will go away after childbirth.

Believe it or not, but Hubby may find it hard to sleep too, during your pregnancy. Whether or not you used to snore, before the pregnancy, you are likely to do so now, especially during the third trimester. Snoring during pregnancy happens due to an increase in the amount of blood in your body and blood vessel expansion, which leads to swollen nasal membranes. You may also suffer from sleep apnea, which much like the other night discomforts, will dissolve after childbirth.

If you are feeling that your memory is betraying you during your pregnancy, you are not imagining things. Research shows that elevated hormone levels during pregnancy affect the brain and can cause forgetfulness.

Forgetfulness is most common in the first and third trimesters. If you think about it, it actually makes sense: during the first trimester your thoughts are occupied by many factors. You may worry about the health of your baby, the future of your family and how your lives will change, the pregnancy and how it will affect your body and so on. In your third trimester you will be anxious to meet your unborn baby and may be worrying or even fearing the near birth. You may also be exhausted if you have had trouble sleeping or discomfort carrying the baby weight. It is only logical that your mind is ‘not all there’ when it comes to other matters.

Forgetfulness during pregnancy is more evident with new tasks, such as trying to memorize new information. It will be harder to memorize new information while pregnant, but old information will not be forgotten.

To overcome this obstacle, come up with strategies to help you remember what is important. Do not be hard on yourself when you cannot remember something, like a phone number or a task you where just about to do. Instead, make yourself a list of your tasks or carry your phone book with you in your purse. Find ways to make your life easier while you go through this temporary phase of forgetfulness.

It may also be a cue that you are asking too much of yourself. After all, you are pregnant, and whenever possible, you should give yourself a break or try to slow things down. Prioritize and realize you cannot do it all, even if you really want to. You do not have to wash all the new baby clothes you have received or paint the nursery, today. Remember that your health affects your baby’s health directly. And while it may not feel like it, this pregnancy is only temporary.

An ectopic pregnancy is a pregnancy outside the uterus. When an embryo implants in the fallopian tubes, ovary or another abdominal organ other than the uterus, it is considered an ectopic pregnancy. This condition is life threatening and requires emergency treatment.

Chances for an ectopic pregnancy are around 2%.

Symptoms include:

• Light vaginal bleeding.
• Nausea and vomiting.
• Lower abdominal pain.
• Sharp abdominal cramps.
• Pain on one side of the body, or around the hip.
• Dizziness or weakness.
• Pain in the shoulder, neck, or rectum.
• HCG levels do not double.

An ectopic pregnancy can occur because of a damaged fallopian tube. In this case the fertilized egg may not be able to make its way to the uterus and implant in the fallopian tube or elsewhere, instead. Another reason for such a pregnancy is due to scar tissue build up in the fallopian tube that the egg gets caught on.

Other causes for an ectopic pregnancy include:

• Use of an  IUD at the time of conception.
• History of pelvic inflammatory disease.
• Sexually-transmitted diseases.
• Congenital abnormality of the fallopian tube.
• History of pelvic surgery.
• History of ectopic pregnancy.
• Unsuccessful tubal ligation (surgical sterilization) or tubal ligation reversal.
• Fertility drugs.
• Infertility treatments such as in vitro fertilization (IVF).
• Smoking.

If you have had an ectopic pregnancy, you can still have a healthy pregnancy! Speak to your healthcare provider about your risks and chances with regard to conception and how to carry a healthy pregnancy to term after having had an ectopic pregnancy.

Nine months, or forty weeks as they calculate pregnancy, can seem like a very long time when you are expecting your first child. Excitement levels are high and time passes slower and slower with the added weight and increased inconvenience to your changing body. But nine months are really not that long of a time span for all there is to do in preparation for your newborn.

First time moms can find it overwhelming to deal with it all at the same time, therefore planning ahead and researching in advance can make your life that much more pleasant and stress free after your baby is born.

What is there to research and plan for? Here are a few things you may want to think about before you meet your bundle of joy:

• Finding the right Pediatrician for you and your baby can take time. If you have friends with kids, start interviewing them for recommendations. You can also speak to your OBGYN and see if he/she can recommend a good doctor. It is important to find someone you see eye to eye with. After all, they will be caring for your child and be recommending treatments and approaches that affect your child’s health directly.

• Breastfeeding or Formula – Consider your choices and learn about them. It is a personal choice and you are the one who needs to feel confident about it, so don’t let others steer your decision. Learn about the benefits of breastfeeding. Talk to your friends who have breastfed; it will give you an idea if it is for you or not. If it is not, there are other options. In that case, research the different brands and kinds of breast milk supplements that are available to you.

• Some expecting moms spend hours if not days designing their baby’s Nursery. While it is not a must, it is good to know what is out there to make your choice about your baby’s environment. You may choose to co-sleep, in which case, you will not need a crib or bassinet right away. If you plan to breastfeed, you may want to consider purchasing a rocking chair. And the list goes on and on.

• You may decide to wait for the baby shower to see what Clothes + Toys + Accessories you will get before you go out to the store. Or maybe you want to go to the store first and explore the endless designs available and create a registry so you will get exactly what you want.

• Daycare. It is never too early to research daycares if you plan on sending your baby to one. By regulation they are allowed a specific number of babies per teacher, and the good ones fill up faster than you can imagine. Call up the ones you are considering and ask about registration, their schedule (to see that it leaves you enough time to get to and from work), ratio of babies to caregivers and anything that will put you at ease leaving your little one there.

And the list goes on and on.  So, are nine months really that long?

When you are expecting and are anxious to meet your baby, nine months may seem like a long time. But time flies between work, doctor visits and preparing for both the actual pregnancy and the arrival of your newborn.

Here are a few things to put on your to do list:

• It goes without saying that once you find out you are pregnant, you need to find an OBGYN or a Midwife to be your caregiver throughout the pregnancy. If you are not sure which is best suited for you, this is the time to learn the differences and make your educated choice.

• You will not need Maternity clothes right away, but when the time comes, don’t resist it. The weight gain is normal and healthy (unless otherwise noted by your caregiver) and there is no reason not to embrace and celebrate it. The beautiful curves of pregnancy can be enhanced with the right fit maternity clothes and make you feel and look better about the changes your body is going through.

• During your first prenatal visit, you will be asked about your work environment to determine if it is safe for you and your baby to continue what you do during your pregnancy, or if you need to make adjustments at work. This is for the health and safety of both you and your unborn baby.

• Deciding when to tell your employer about your pregnancy is up to you. There is no law requiring you to share your news at a specific point in the development of your pregnancy. Telling your employer can result in a sympathetic attitude, leading to better terms or more leniencies toward your situation. At the same time, your employer may not be so understanding. Make your decision based on your situation at work.

• You may want to consider seeking a Photographer to commemorate this special time in your life. It is usually best to have your maternal photo shoot between the fifth and seventh month of pregnancy, when you look and feel best. Earlier than those months, you may not be showing, and later, you may feel too heavy to do anything like this.

• Learn about Maternity leave in your state. It may look like you have lots of time before you will need to know the facts about maternity leave, but time flies and it is always smart to do your research in advance. This way, if you are not eligible for maternity leave, you’ll be prepared and make the necessary arrangements.

Revise your list to reflect the things you would like to get accomplished before your life will change completely…and for the better!

With your first pregnancy, everything is new and exciting. Nevertheless, it can also be scary!  Worrying about what you do not know or what to expect ahead is common. It is normal to fear the unknown and that is why there are birth preparation classes. Knowledge is power, as they say, rightfully so.

When you start your third trimester, your healthcare provider will explain some signs of early / preterm labor and when you should call, or go to triage. It is important to know these signs because it will help you recognize when you need to go to the hospital. Some labor signs (a few weeks or even days away), include:

It is said that Nesting is a good sign that your baby is on its way, but it is not a clinical sign.  Those who experience nesting have sudden bursts of energy toward the end of their pregnancy.  After a long period of fighting the fatigue that can take over with pregnancy, you will find yourself full of energy and excited to start cleaning, organizing and getting ready for your newborn.

After long weeks of feeling heavy, and rightfully so, you can suddenly breathe again. Lightening is an indication that baby has dropped, settling deeper into your pelvis. While the pressure is off your diaphragm, your bladder is the next victim in line, which means frequent visits to the restroom. All in all, it is a sign that your baby is getting ready to start its way out, which is cause for celebration in itself, even if it is spent going to the bathroom every five minutes.

It is said that the loss of mucus plug is often the first sign that labor is approaching. This thick plug of mucus protects your cervical opening from bacteria enters the uterus during your pregnancy. When your cervix begins to thin and relax, this plug is expelled. The mucus plug may be clear, pink or blood tinged and can appear minutes, hours or even days before labor begins.

Possibly the most famous sign of labor is the rupture of membranes, or more commonly referred to as your water breaking. You should know that only 1 in 10 women experience this dramatic gush of amniotic fluid and can break before labor begins. If you experience rupture of membranes, first you need to determine if it is urine or amniotic fluid. The difference is in the odor. The amniotic fluid is odorless. Once you know it is not urine, contact your healthcare provider for future instructions.

When you begin to experience regular uterine contractions, you are in labor. This is a good time to start timing your contractions and see how long they are and how far apart. Contractions may feel like menstrual cramps or a lower backache that comes and goes, and during early labor, they may be as far apart as 20 to 30 minutes. Over the course of several hours,your contractions will begin to occur at shorter intervals; and you may notice themto start happening every 10-15 minutes or less. When your contractions are consistently 5 minutes apart, it is time to call your health care provider.

Contractions are:

• Regular
• They follow a predictable pattern
• They become progressively closer
• They last progressively longer
• They become progressively stronger
• Each contraction is felt first in the lower back and then radiates around to the front or visa versa
• A change in activity or position will not slow down or stop contractions
• Blood may appear
• Membranes may rupture
• Your health care provider will notice cervical changes, ie. effacement (thinning) or dilation

Keep calm and remember, knowledge is power!

You may not realize it, but exercising throughout your pregnancy can benefit you greatly. Even though you may not be up for competitive sport, light exercise that is adjusted for this special time in your life will help you feel better throughout the pregnancy.  Specialists say that any kind of exercise may lead to an easier delivery (depending on the type of exercise you do) and will even help you lose the pregnancy weight after childbirth. What can be better than that?

If you did not exercise regularly before, you should speak to your healthcare provider and even a trainer to develop the appropriate exercise plan for your pregnancy. Make sure you do not over do it!  Keep your heart rate under 140 during your third trimester (for more information, speak to your healthcare provider about your personal medical history and what will be best for you).  If you have certain medical conditions or if your pregnancy is considered high risk, exercising may not be recommended. Therefore you should not start exercising on your own if you have not done so regularly prior to your pregnancy

Pregnancy exercising can help you:

Boost your energy. Now that your body is changing, and your energy levels are lower than usual, exercising can help you feel better and boost up your energy. You will be pleasantly surprised that after a good workout, you will feel refreshed, even during the first trimester (which can be the most drowsy trimester).

Reduce aches and pain. It will also help relieve backaches you may be experiencing and improve your posture by strengthening and toning muscles in your back, butt, and thighs.

Relieve discomforts. Exercising will help reduce constipation by accelerating movement in your intestine, prevent wear and tear on your joints (which loosen during pregnancy due to normal hormonal changes) by activating the lubricating fluid in your joints and help you sleep better by relieving the stress and anxiety that might make you restless at night.

Prepare for labor. The stronger your body is, the more prepared it will become for childbirth. You will have an easier time managing pain and have a better control over your breathing technique.