When pregnant, you may be concerned about weight gain. On one hand, you may fear that ‘eating for two’ will lead to excessive weight gain that will be hard to get rid of after childbirth. On the other hand, you don’t want to eat too little, so that your baby’s development will suffer.

During pregnancy, proper nutrition is extremely important. It not only affects the healthy development of your baby, but also keeps you healthy. Therefore, many women wander what is considered a healthy weight gain, can they be on a diet during pregnancy, and when can they start a diet to lose weight after childbirth.

Normal weight gain during pregnancy is about 25-35 pound for a single embryo pregnancy (more for multiples). Of course only a small portion of this weight is fat.  The baby weight 7-8 pounds, the placenta is 1-2 pounds and the amniotic fluid in which the baby is surrounded weigh about 2 pound. Total 10-12 pound, which ‘disappear’ after childbirth.

In addition, the uterus grows by 2 pounds, maternal breast tissue weigh about 2 pounds and blood volume increase by about 4 pounds. Some women suffer from water retention, which may add about 3 pounds.

So far 18-20 pounds increase total, which does not include the 7 pound of fat and nutrients you are storing for breastfeeding. Total 25-27 pounds.

It is important to stress that each women will gain weight at different speed and amount, so do not worry if your weight gain is different than another women. If you have any concerns speak to your healthcare provider.

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?

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.

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.

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.