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How Monkeys Compete to Groom their Babies

There is nothing sweeter and cuter than a newborn baby - human or otherwise. Parents are very protective of their little ones for good cause. If it's their first, hysteria seems to plague the parents. This usually subsides after the second or third baby.
Vervet monkeys and sooty mangabeys are no different when it comes to others touching their newborns. Most animals are this way, so there's no breaking news regarding that. However, what makes this story unique is the "marketing" parents of newborn monkeys employ.

"Monkey babies attract crowds of females eager to touch, hold and make silly lip-smacking noises at the little ones." She decided to study these two monkey species in the wild and recorded their behaviors. Her findings revealed that vervet and mangabey mothers have a "touching etiquette that is uncommon in the animal world. This silently understood market places a high price on fondling babies in these two species.

For the price of grooming the mother, the interested party can fondle the baby. However, the amount of time grooming didn't instantly earn the interested fondler equal fondling time. In other words, grooming also coincided with familiarity with the mother. So, a relative or friend of the mother was granted more intimate fondling with less grooming time than a stranger. The stranger could groom until the cows came home and would never be able to pick up the baby.

Also what affected the "fondling market" for baby monkeys in these two species was the amount of babies in the group. If there was a large supply of babies, the mother was less likely to get much grooming.

If the baby born in the group was the only one, the mother was discovered to earn at least 10 minutes of grooming. However, only a few minutes of grooming was given to the mother who was one of many who just had a baby.

The age of the baby also affects the "market value". The magical age for baby to lose fondling interests is roughly three months of age. At this point, the crowds retreat and the mother is left to groom herself.

You may wonder about ranking in the monkey groups. This also affects the "fondling market." Higher ranking monkeys get more grooming time, whereas a socially outcast, nerdy monkey gets much less.

This study suggests that chacma baboons and long-tailed macaques have a similar market on grooming to fondling pricing. Interestingly, the spider monkey also has a "fondling market." However, with the spider monkey, they hug the mom, not groom her.

This study shows that whether one agrees or not that humans came from monkeys, one thing is for sure. There are celebrities and favoritism in all species. Some species even put a price on the touching of their young.

Did you know, monkeys have 12 hairs at any one time    

Birth Control

Birth control is this topic for you?

Sometimes a woman may not use birth control, or her method may fail. If this happens to you, you may still be able to prevent pregnancy if you act quickly. For more information, see the topic Emergency Contraception.

What is birth control?

Birth control is any method used to prevent pregnancy. Another word for birth control is contraception (say "kon-truh-SEP-shun").

If you have sex without birth control, there is a chance that you could get pregnant. This is true even if you have not started having periods yet or you are getting close to menopause. Each year, about 85 out of 100 women who don't use birth control have an unplanned pregnancy.

The only sure way to prevent pregnancy is to not have sex. But finding a good method of birth control you can use every time can help you avoid an unplanned pregnancy.

What are the types of birth control?

There are many different kinds of birth control. Each has pros and cons. Learning about all the methods will help you find one that is right for you.

• Hormonal methods include birth control pills, shots (Depo-Provera), the skin patch, the implant , and the vaginal ring. The Mirena IUD, with levonorgestrel, is also considered a hormonal method of birth control. Birth control that uses hormones is very good at preventing pregnancy.
• Intrauterine devices (IUDs) are inserted into your uterus. IUDs work very well for 5 to 10 years at a time and are very safe. And the Mirena IUD contains a hormone that can help with heavy periods and cramping.
• Barrier methods include condoms, diaphragms, and sponges. In general, these do not prevent pregnancy as well as IUDs or hormonal methods do. Barrier methods must be used every time you have sex.
• Natural family planning (also called fertility awareness) can work if you and your partner are very careful. You will need to keep good records so you know when you are fertile. And during times when you are fertile, you will need to skip sex or use a barrier method.
• Permanent birth control (sterilization) gives you lasting protection against pregnancy. A man can have a vasectomy, or a woman can have her tubes tied (tubal ligation). But this is only a good choice if you are sure that you don't want any (or any more) children.
• Emergency contraception is a backup method to prevent pregnancy if you forget to use birth control or a condom breaks.

For hormonal or barrier methods to work best, you have to use them exactly the way your doctor or the package instructions say. Even then, accidents can happen. So it is a good idea to keep emergency birth control on hand as backup protection. You can buy "morning-after pills" called Plan B in most drugstores if you are 17 or older.

How do you choose the best method?

The best method of birth control is one that protects you every time you have sex. And with many types of birth control, that depends on how well you use it. To find a method that will work for you every time, some things to think about include:

• How well it works. Think about how important it is to you to avoid pregnancy. Then look at how well each method works. For example, if you plan to have a child soon anyway, you may not need a very reliable method. If you don't want children but feel it is wrong to end a pregnancy, choose a type of birth control that works very well.
• How much effort it takes. For example, birth control pills may not be a good choice if you often forget to take medicine. If you are not sure you will stop and use a barrier method each time you have sex, pick another method.
• When you want to have children. For example, if you want to have children in the next year or two, hormone shots may not be a good choice. They can make it hard to get pregnant for several months after you stop them. If you never want to have children, natural family planning is not a good choice because it often fails.
• How much the method costs. For example, condoms are cheap or free in some clinics. Some insurance companies cover the cost of prescription birth control. But cost can sometimes be misleading. An IUD costs a lot up front. But it works for years, making it low-cost over time.
• Whether it protects you from infection. Latex condoms can help protect you from sexually transmitted diseases (STDs), such as HIV. But they are not the best way to prevent pregnancy. To avoid both STDs and pregnancy, use condoms along with another type of birth control.
• If you've had a problem with one kind of birth control. Finding the best method of birth control may involve trying something different. Also, you may need to change a method that once worked well for you.

If you are using a method now that you are not happy with, talk to your doctor about other choices.

What health issues might limit your choices?

Some birth control methods may not be safe for you, depending on your health. To make sure a method is right for you, your doctor will need to know if you:

• Smoke.
• Are or could be pregnant.
• Are breast-feeding.
• Have any serious health problems, such as heart disease, high blood pressure, migraine headaches, or diabetes.
• Have had blood clots in the legs (deep vein thrombosis) or lungs (pulmonary embolism), or have a close family member who had blood clots in the legs or lungs.
• Have ever had breast cancer.
• Have a sexually transmitted disease.

How can you get birth control?

You can buy:

• Condoms, sponges, and spermicides in drugstores without a prescription.
• Plan B emergency birth control in most drugstores without a prescription. But you do need proof that you are 17 or older.

You need to see a doctor or other health professional to:

• Get a prescription for birth control pills and other methods that use hormones.
• Have an IUD inserted.
• Be fitted for a diaphragm or cervical cap.

Some pharmacists will not sell Plan B or fill prescriptions for birth control pills. If this happens to you, ask for the location of a pharmacist who will, or go to:

• The Emergency Contraception Web site at http://ec.princeton.edu, or call 1-888-NOT-2-LATE (1-888-668-2528).
• The Planned Parenthood clinic nearest you, or call 1-800-230-PLAN (1-800-230-7526).

Labor and Delivery Interventions

Your Birth Choices
We all hope that childbirth will go smoothly. Most women are dreaming of a nice, quick labor and birth. However, some women will have complications or require interventions due to issues like induction. Some of these interventions include: IV, fetal monitoring, breaking your water with an amnihook, forceps or a vacuum extractor. Here is information on these practices in labor and birth, including what they are and how to try to avoid them.

Sometimes interventions are used because it is the common thing to do and not because it is absolutely necessary. This is where a birth plan, a good relationship with your doctor or midwife and informed consent comes in. These ingredients are important for you to be able to make the best decision for you and your family.

There is also an effect known as the cascade of interventions. This basically states that once you have one intervention it makes more interventions more likley to be needed. To minimize the effects of the cascade of interventions one needs to be able to try and pick and choose only the interventions really necessary and to actively work to counteract potential side effects from the intervention when possible. Your doctor, midwife, nurse or doula can help you figure out how to minimize side effects from the interventions used in your labor and delivery experience.

IV Fluids in Labor

There are many reasons why an IV might be used in labor and birth. For low risk mothers, an IV might be used if you are having an induction or epidural anesthesia. A high risk mother might be requested to use one for a just in case manner.

You can still get up and move around with an IV. You simply need to request a pole that has wheels. This means that you can maintain your mobility and still assume comfortable labor positions.

Alternatives to an IV include oral hydration by eating ice chips or by a normal diet or special labor diet of clear liquids and light foods.

Breaking Your Water (Amniotomy)

This is the artificial rupture of membranes. It is supposedly done to "speed up" labor, though most studies say that this is not true for most women. 75 of the time your water will break past nine centimeters. Amniotomy may also be used to assess if the baby has passed meconium or to allow the insertion of internal fetal monitoring.

It is done by placing a amniohook (looks very similar to a long crochet hook) inside the vagina during a vaginal exam and scratching the bag until it ruptures.

Drawbacks to this can include:

• Increased risk of infection
• Lack of cushion for the baby's head
• Increased intervention, and limited mobility
• There are other ways to speed labor, including walking, nipple stimulation, position changes, etc.
• Amniotomy may also be used as an induction technique.

External Fetal Monitoring - Electronic Fetal Monitoring (EFM)

Fetal monitoring is a catch all term to talk about how we watch your baby during labor. Fetal monitoring is done by both a midwives and doctors at home births, birth center births or hospital births.

The type of monitoring you will need for your labor will depend on where you are giving birth, who your practitioner is and how complicated your pregnancy and labor are. There are several types of monitoring:

• Auscultation with fetoscope
• Hand held doppler device
• External electronic fetal monitoring by ultrasound
• Internal electronic fetal monitoring with or with an internal uterine pressure catheter (IUPC)
• You may require fetal monitoring due to the added risks to the baby if you have an epidural, pitocin, induction or other high risk situations like meconium staining, which may indicate fetal distress. 

Monitoring a low risk woman is less intensive than the woman with a high risk pregnancy. Though in general, studies have shown that an increase in monitoring, particularly for low risk women, has not improved pregnancy outcomes, but it has increased the intervention rates, like cesarean section.

Internal Fetal Monitoring (IFM) - Continuous Electronic Fetal Monitoring
 
Internal fetal monitoring is used for high risk births or during a normal birth where the birth team is having trouble keeping the baby on the monitor or the baby's reaction doesn't look great on the less accurate form of external fetal monitoring (EFM).

With internal fetal monitoring the mother's bag of waters must be broken. If it has not broken on it's own then an amniotomy will be performed to break the water. A fetal scalp electrode is placed by screwing a tiny sire into the top layers of the baby's scalp, then relaying the baby's heart rate to the fetal monitor. This is more accurate because it does not use ultrasound.

At the same time an intrauterine pressure catheter (IUPC) can also be placed inside the uterus.
It goes between the uterine wall and the baby. This also allows the midwife or doctor to know the exact force from the contractions, rather than a simple graphical representation given by external monitoring. This is very useful in the case of induction.

Internal monitoring can also prevent an unnecessary cesarean for fetal distress if it shows the baby is healthy, compared to the less accurate external monitoring. Though there are risks associated with the internal monitor:

• Risk of infection for mom and baby
• Restricts movement of the mother
• Reduction in movement can cause more pain
• Intrauterine Pressure Catheter (IUPC)

The Intrauterine Pressure Catheter (IUPC) is often used in labor induction to help measure the exact force of the contractions during labor. This can help your doctor or midwife determine the amount of pitocin (labor inducing medication) to use. The IUPC may also be used when internal fetal monitoring is used.

To use the IUPC your water must be broken.

Forceps in Labor & Delivery
 
There are several shapes and sizes of forceps, but they do look remarkably similar to salad tongs. These are slipped, one at a time, inside the mother's body and then locked around the baby's skull. The practitioner will then pull with the mother's pushes. This can sometimes bruise the baby and the mother.

Forceps are used in a graded system: high, mid, and low or outlet forceps. When you hear of the forceps horror stories it was usually from the high forceps, which has now nearly universally been replaced by cesarean section.

Mid forceps has mostly been replaced by the use of vacuum extraction and cesarean, leaving only low or outlet forceps to be used.

Forceps have different properties than the vacuum extractor:

• Can be used to turn a baby in a different position (i.e. posterior baby)
• Can cause more trauma to mother's tissues
• Can cause less trauma to baby 

 

Vacuum Extraction - Labor & Delivery 

Vacuum extraction is a cup like device that is either attached to a suction device on the wall or by a manual suction pump. It is placed on the back of the baby's head and the suction is increased so that the practitioner pulls with the mother's pushes.

 

Vacuum extractors have different properties than the forceps:

• Can be used higher than forceps
• Can cause less trauma to mother's tissues
• Can cause more trauma to baby

Alternatives may include changing the mother's position, including the use of a deep squat or the use of forceps or cesarean section.

Epidural Anesthesia

Epidural anesthesia is a common form of medicinal pain relief. Knowing what there is to know about epidural basics as well as the policy of your hospital and practitioners is an important part of making your epidural a pleasant experience.

Using an epidural does increase the necessity of certain interventions like the IV, fetal monitoring and others. You may also be at a higher risk for the need for an augmentation of labor (speeding labor up), internal fetal monitoring and potentially a cesarean section.

Cesarean Section

A cesarean section is also known as a c-section, which is sometimes also written as c/s. This type of birth is done by a surgical incision in the abdomen and uterus to allow a baby or babies to be born safely when a vaginal birth is not the safest route. The current cesarean rate in the United States is over 30%, which concerns the majority of experts, including the World Health Organization (WHO).

Prenatal Care During Pregnancy

The Importance of Prenatal Care

Almost 4 million American women give birth every year. Nearly one third of them will have some kind of pregnancy-related complication. Those who don't get adequate prenatal care run the risk that such complications will go undetected or won't be dealt with soon enough. That, in turn, can lead to potentially serious consequences for both the mother and her baby.
These statistics aren't meant to be alarming, but to convey the importance of starting prenatal care as early as possible — ideally, before a woman even becomes pregnant.
Of course, this isn't always possible or practical. But the sooner in a pregnancy good care begins, the better for the health of both moms and their babies.

Prenatal Care Before Becoming Pregnant

Ideally, prenatal care should start before you get pregnant. If you're planning a pregnancy, see your health care provider for a complete checkup. Routine testing can make sure you're in good health and that you don't have any illnesses or other conditions that could affect your pregnancy. If you've been experiencing any unusual symptoms, this is a good time to report them.
If you're already being treated for a chronic condition, such as diabetes, asthma, hypertension (high blood pressure), a heart problem, allergies, lupus (an inflammatory disorder that can affect several body systems), depression, or some other condition, you should talk to your doctor about how it could affect your pregnancy.
In some cases, you may need to change or eliminate medications — especially during the first trimester (12 weeks) — to reduce risk to the fetus. Or, you may need to be even more vigilant about managing your condition. For example, women with diabetes must be especially careful about keeping their blood glucose levels under control, both before they begin trying to conceive and during their pregnancy. Abnormal levels increase the risk of birth defects and other complications.
This is also a good time to talk with your health care provider about other habits that can pose a risk to your baby, such as drinking alcohol or smoking. Ask about starting a prenatal vitamin that contains folic acid, calcium, and iron.
It's especially important for women who are planning to become pregnant to take vitamins with folic acid beforehand, because neural tube defects (problems with the normal development of the spine and nervous system) happen in the first 28 days of pregnancy, often before a woman even knows she's pregnant.
If you have or your partner has a family history of a significant genetic disorder and you suspect either of you may be a carrier, then genetic testing may be advisable. Talk this over with your health care provider, who can refer you to a genetic counselor if necessary.
If you find out that you're pregnant before you do any of this, don't worry. It's not too late to get the care that will help to ensure your health and that of your baby.

Finding Medical Care

Pregnant women usually are cared for by:

• obstetricians (doctors who specialize in pregnancy and childbirth)
• obstetricians/gynecologists (OB/GYNs) (doctors who specialize in pregnancy and childbirth, as well as women's health care)
• family practitioners (doctors who provide a range of services for patients of all ages — in some cases, this includes obstetrical care — instead of specializing in one area)
• certified nurse-midwife (an advanced practice nurse specializing in women's health care needs, including prenatal care, labor and delivery, and postpartum care for pregnancies without complications)

Any of these care providers is a good choice if you're healthy and there's no reason to anticipate complications with your pregnancy and delivery. However, nurse-midwives do need to have a doctor available for the delivery in case a cesarean section has to be performed.
Your health care provider may refer you to a doctor with expertise in high-risk pregnancies if you:

• have a chronic condition like diabetes or heart problems
• have an increased risk of preterm labor
• are older than 35
• are pregnant with more than one fetus
• have some other complicating factor that might put you in a high-risk category

Even if your pregnancy isn't high risk, this may still be a good time to make a change in health care providers if you're not comfortable with your current doctor.

Your First Visit

You should call to schedule your first examination during the first 6 to 8 weeks of your pregnancy, or when your menstrual period is 2 to 4 weeks late. Many health care providers will not schedule the first visit before 8 weeks, unless there is a problem.
During your first visit, you'll be asked a lot of questions about your health and habits that may have an impact on your pregnancy. It's important to try to remember the date of your last menstrual period so your doctor can estimate the duration of your pregnancy and predict your delivery date.
You can expect to have a full physical, including a pelvic and rectal examination. A blood sample will be taken and used for a series of tests:

• a complete blood cell count (CBC)
• blood typing and screening for Rh antibodies (antibodies against a substance found in the red blood cells of most people)
• for infections such as syphilis, hepatitis, gonorrhea, chlamydia, and human immunodeficiency virus (HIV)
• for evidence of previous exposure to chickenpox (varicella), measles (rubeola), mumps, or German measles (rubella)
• for cystic fibrosis (health care providers recently started to offer this even if there's no family history of the disorder)

Some blood tests are offered only to women of certain ethnic backgrounds, who may be at higher risk of carrying genes for specific diseases. For example, women of African or Mediterranean descent are usually tested for thalassemia or sickle cell trait or disease because they're at higher risk of these chronic blood diseases or carrying the sickle cell trait, which can be passed on to their children.
Women of Ashekenazi Jewish heritage (Jews of central and eastern European descent) and women of French-Canadian/Cajun heritage are at increased risk for carrying the genes for Tay-Sachs disease.
Talk with your health care provider to see if any of these genetic tests may be recommended for you.
During the first visit, you also can expect to provide a urine sample for testing and to have a Pap test (or smear) for cervical cancer. To do a Pap smear, the doctor uses what looks like a very long mascara wand or cotton swab to gently scrape the inside of the cervix (the opening to the uterus that's located at the very top of the vagina). This generally doesn't hurt; some women say they feel a little twinge, but it only lasts a second.

Routine Visits and Testing

If you're healthy and there are no complicating risk factors, you can expect to see your health care provider:

• every 4 weeks until the 28th week of pregnancy
• then every 2 weeks until 36 weeks
• then once a week until delivery

At each examination, your weight and blood pressure are usually recorded. The size and shape of your uterus may also be measured, starting at the 22nd week, to determine whether the fetus is growing and developing normally.
During one or more of your visits, you'll be asked to provide a small urine sample to be tested for sugar and protein. Protein may indicate preeclampsia, a condition that develops in late pregnancy and is characterized by a sudden rise in blood pressure and excessive weight gain, with fluid retention and protein in the urine.
Screening for diabetes usually takes place at 12 weeks for women who are at higher risk of having gestational diabetes (diabetes that occurs during pregnancy). That includes women who:

• have previously had a baby that weighs more than 9 pounds (4.1 kilograms)
• have a family history of diabetes
• are obese

All other pregnant women are tested for diabetes at 24 to 28 weeks. This test involves drinking a sugary liquid and having a blood glucose test (which involves having blood drawn) after an hour. If the sugar level in the blood is high, further testing might be done to diagnose gestational diabetes.

Prenatal Tests

Many expectant parents also choose to have one or more of the following prenatal tests, which can help predict the likelihood, or even detect the presence, of certain developmental or chromosomal abnormalities in the fetus:
First trimester screening: Between 10 and 14 weeks, your doctor might recommend a blood test to measure two substances — pregnancy-associated plasma protein (PAPP-A) and hCG (human chorionic gonadotropin), both produced by the placenta in early pregnancy. You also might be sent for an ultrasound test for fetal nuchal translucency, which measures the amount of fluid at the back of your developing baby's neck.
Second trimester screening: Between 16 and 18 weeks, the level of alpha-fetoprotein, a protein produced by the fetus, can be measured in a pregnant woman's blood. If the level is high, she may be carrying more than one fetus or a fetus with spina bifida or other neural tube defects. A high level can also indicate that the date of conception was miscalculated. If the level is low, the fetus may have chromosomal abnormalities, such as Down syndrome.
Along with AFP, two hormones produced by the placenta are often measured — hCG and estriol. The level of these three substances can help doctors identify a fetus at risk for certain birth defects or chromosomal abnormalities. When all three are measured, the test is called the triple screen or triple marker. Often a fourth placental hormone is measured, called Inhibin-A. In this case, the test might be called the quadruple screen, quad screen, quadruple marker, quad marker, or multiple marker screening.
Sometimes both first and second trimester screening tests are done. This is called an integrated screening test.
It's important to keep in mind that abnormal results of screening tests don't automatically indicate a problem; rather, they indicate the need for further testing, which yields normal results in many cases.
Additional testing that might be recommended can include the following:
Amniocentesis (also called an amnio): In this test, a needle is used to remove a sample of the amniotic fluid from the womb; it's usually performed between 15 and 20 weeks. Testing the fluid can identify certain fetal abnormalities such as Down syndrome or spina bifida. Typically, amniocentesis is recommended only if there is reason to believe that the risk for such conditions is higher than usual, perhaps due to maternal age (35 or older), abnormal screening results, or family history. Although the test poses a small risk for causing preterm labor and inducing miscarriage, the large majority are performed without any problem.
Chorionic villus sampling (CVS): This procedure is used during the first trimester for the same purposes as an amniocentesis. (Women usually have one or the other, but not both, if such testing is deemed necessary.) It involves taking a sample of the tissue that attaches the amniotic sac (the sac around the fetus) to the wall of the uterus. Like amniocentesis, CVS is typically done only when there are certain risk factors; its primary advantage is that results are available sooner. CVS also carries a slightly increased risk of miscarriage and other complications.
Ultrasound (also called a sonogram, sonograph, echogram, or ultrasonogram): You'll likely have at least one ultrasound examination to make sure the pregnancy is progressing normally and to verify the expected date of delivery. Usually, an ultrasound is performed at 18 to 20 weeks to look at the baby's anatomy, but can be done sooner or later and sometimes more than once. An ultrasound poses no risk to you or your baby.
Some health care providers may have the equipment and trained personnel necessary to provide in-office ultrasounds, whereas others may have you go to a local hospital or radiology center.
Wherever the ultrasound is done, a technician will coat your abdomen with a gel and then run a wand-like instrument over it. High-frequency sound waves "echo" off your body and create a picture of the fetus inside on a computer screen.
Ultrasound scanning is used to:

• determine whether the fetus is growing at a normal rate
• record fetal heartbeat or breathing movements
• see whether you might be carrying more than one fetus
• identify a variety of abnormalities that might affect the remainder of the pregnancy or delivery

There are ultrasounds available at shopping malls as a way to have a "portrait" of your baby. However, the individuals using the equipment are not necessarily trained as ultrasound technicians. Before committing to having one of these done, it would be wise to discuss it with your health care provider.

Common Concerns

Some women are concerned about preexisting medical conditions, such as diabetes, and how they could affect a pregnancy. It's important to discuss these concerns with your doctor, who may recommend a change in medication or treatment approaches that could ease your concerns.
Whether or not you have a preexisting condition, you may be concerned about some of the other conditions that can be associated with pregnancy including:

• gestational diabetes: Up to 8% of pregnant women develop this condition, usually after the first trimester. During pregnancy, the placenta, which provides the fetus with nutrients and oxygen, also produces hormones that change the way insulin works. Insulin is a substance that's made by the pancreas. It helps the body store the sugar in food so that later it can be converted to energy. When someone has gestational diabetes, the problem with the insulin leads to a high blood sugar level as well.
• preeclampsia (also called toxemia of pregnancy): An abnormal condition that develops after the sixth month, it causes high blood pressure, edema (accumulation of fluid in body tissues resulting in swelling of the hands, feet, or face), and protein in the urine.
• Rh-negative mother/Rh-positive fetus (also called Rh incompatibility): Rh factor is a substance found in the red blood cells of most people (a simple blood test can determine your Rh factor). If you don't have it, then you're considered Rh negative. If your baby does have the factor and is Rh positive, problems can result when the baby's blood cells enter your bloodstream. That's because your body may react by producing antibodies that can pass into the fetus' bloodstream and destroy red blood cells.

These conditions are serious but manageable, so it's important to educate yourself about them and discuss them with your health care provider.
Pregnant women also frequently worry about weight gain. It's generally recommended that a woman of normal weight gain approximately 25 to 35 pounds during pregnancy. For women who start their pregnancy overweight, total weight gain should be closer to 15 to 25 pounds. And those who are underweight should gain 28 to 40 pounds.
Pregnancy is not a good time to start a diet; however, it can be a great time to start eating healthy food if you didn't before. It's also a good time to get regular, low-impact exercise.
Controlling weight gain is more difficult later in a pregnancy, so try to avoid gaining a lot of weight during the first few months. However, not gaining enough weight can cause problems too, such as inadequate fetal growth and premature labor.

Taking Care of Yourself

For your baby's sake and yours, it's important to take especially good care of yourself during your pregnancy. Follow the basics:

• Don't smoke, drink alcohol, or take drugs.
• Get enough rest.
• Eat a healthy diet.

Doctors generally recommend that women add about 300 calories to their daily intake to provide nourishment for the developing fetus. Although protein should supply most of these calories, your diet needs to be well-balanced, including fresh fruits, grains, and vegetables. Your health care provider will likely prescribe a prenatal vitamin to make sure you get enough folic acid, iron, and calcium.
Over-the-counter medications are generally considered off-limits because of their potential effects on the fetus. Most doctors will recommend that you don't take any OTC medications at all, but they might offer a list of those they think are safe to take. Be sure to discuss any questions about medications, including natural remedies, supplements, and vitamins, with your doctor.
When you're pregnant, it's also important to avoid food-borne illnesses, such as listeriosis and toxoplasmosis, which can be life threatening to an unborn baby and may cause birth defects or miscarriage. Foods you'll want to steer clear of include:

• soft, unpasteurized cheeses (often advertised as "fresh") such as feta, goat, Brie, Camembert, and blue cheese
• unpasteurized milk, juices, and apple cider
• raw eggs or foods containing raw eggs, including mousse and tiramisu
• raw or undercooked meats, fish, or shellfish
• processed meats such as hot dogs and deli meats (these should be well cooked)

You should also avoid eating shark, swordfish, king mackerel, or tilefish. Although fish and shellfish can be an extremely healthy part of your pregnancy diet (they contain beneficial omega-3 fatty acids and are high in protein and low in saturated fat), these types of fish may contain high levels of mercury, which can cause damage to the developing brain of a fetus.
Pregnancy also can cause a number of uncomfortable, although not necessarily serious, side effects, including:

• nausea and vomiting, especially early in the pregnancy
• leg swelling
• varicose veins in the legs and the area around the vaginal opening
• hemorrhoids
• heartburn and constipation
• backache
• fatigue
• sleep loss

If you experience one or more of these side effects, keep in mind that you're not alone! Talk to your doctor about strategies for alleviating any discomfort.

Talking to Your Health Care Provider

When your body is going through physical changes that may be completely new to you, it isn't always easy to talk to your health care provider. Maybe you're wondering whether you can have sex or what to do about hemorrhoids or constipation, or maybe you're feeling a great deal of anxiety about the delivery.
You might feel embarrassed to ask these or other questions, but it's important to do so — your health care provider has probably heard them all before. Keep a running list of questions between your appointments, and take that list with you to each visit.
It's also strongly recommended that you call your doctor immediately if you experience:

• heavy bleeding
• a sudden loss of fluid
• a marked absence of movement by the baby once he or she has begun moving
• more than three contractions in an hour

Pregnancy Fears

Fear and worry are so common for both partners in pregnancy that it has been suggested that we add this to a list of pregnancy symptoms. Nearly every pregnant woman or her partner will worry about something pregnancy related at one point or another. My guess would be multiple worries, multiple times. When asked what worries pregnant women, you get a long list, including:

• miscarriage
• the unknown
• labor
• episiotomy
• being a parent
• cesareans

However, knowing that fear is common doesn't help resolve the matter or answer your questions. Why isn't the baby moving as much as Samantha's baby? Jasmine's practitioner had her take test XYZ and yet your practitioner doesn't believe in it? Your abdomen is much bigger this time, is there more than one baby in there? Or, how about the dream that you had puppies?
 
Some of your concern is fact based and some of it hormonal. After all, how many women have really had puppies? Some of the biggest concerns are the health of your baby. Is there any way to ensure a healthy baby? Or allay your fears in the slightest? Following your practitioner's orders and gathering information are the best ways that I know to deal with worry.
 
Educating yourselves is a really good way to help relieve some of your fears. I recommend a childbirth class for everyone, even if it is your second baby (or more). Asking questions when you see the practitioner, making it a point to write down the answers. Reading pregnancy books is a really good way to educate yourself, although not every book is as accurate as it should be, so ask for recommendations from educators, practitioners, etc.
 
Your concerns and fears will change during each trimester, and they will be different from your partners. We find that men are more honed in on the financial aspects of having a baby and the health of his partner, while the woman is more tuned in to the fear of miscarriage and the health of the baby.
The best thing that you can do is be patient of one another. If you have a specific concern be sure to share that and work towards finding an answer. You can ask your practitioner, your educator, your doula, or any other professional you run into.
 
So, don't be a member of the Worried Wiper Club (W.W.C.) forever!

Early Pregnancy Symptoms

Pregnancy Symptoms

The only way to know for sure you're pregnancy is with a pregnancy test. But there are early symptoms of pregnancy that can alert you to the fact that you may be pregnant and should have a test.

Some women are so attuned to their body and the changes it undergoes with pregnancy that they seem to know from the start they are pregnant. Other women, though, have no suspicion they are pregnant until they miss their first period, which is perhaps the most widely recognized early sign of pregnancy.

Do All Women Get Early Symptoms of Pregnancy?

 

The early symptoms of pregnancy vary from woman to woman and even from pregnancy to pregnancy. So not every woman has the same symptoms or even the same symptoms from one pregnancy to the next. Also, because the early symptoms of pregnancy often resemble what happens right before and during menstruation, you may have some of the symptoms and not recognize them.

What follows is a description of some of the most common early symptoms of pregnancy. It's important to keep in mind that the symptoms may be caused by other things besides being pregnant. So the fact that you notice some of these symptoms does not necessarily mean you are pregnant. The only way to tell for sure is with a test.

 

Early Symptom of Pregnancy: Missed Period

The most obvious early symptom of pregnancy -- and the one that prompts most women to get a pregnancy test -- is a missed period. But not all missed or delayed periods are caused by pregnancy.

Nor are all pregnancies free of periodic bleeding.

Women can experience some bleeding during pregnancy. If you are pregnant, ask your doctor what you should be aware of with bleeding. For example, when is bleeding normal and when is it a sign of an emergency?

You can miss your period because of a number of non-pregnancy-related issues. Excessive weight gain or loss can cause you not to have a period. So can hormonal problems, fatigue, stress, or tension. Some women miss their period when they stop taking birth control pills. But if your period is delayed and there is a possibility you may be pregnant, there's no reason not to get a pregnancy test.

 

Early Symptom of Pregnancy: Spotting and Cramping

A few days after conception, the fertilized egg attaches itself to the uterine wall. This can cause one of the earliest signs of pregnancy -- spotting and, sometimes, cramping. Known as implantation bleeding, this early symptom occurs anywhere from six to 12 days after the egg is fertilized.

The cramps resemble menstrual cramps, and some women mistake them and the bleeding for the start of their period. The bleeding and cramps, however, are slight. Other things that can cause this symptom include the actual start of menstruation, altered menstruation, using a different birth control pill, infection, or abrasion from intercourse.

In addition to bleeding, you may notice a white, milky discharge from your vagina. This is related to the fact that, almost immediately after conception, the vaginal walls begin to thicken. It is the increased growth of cells lining the vagina that causes the discharge. This discharge can continue throughout your pregnancy, but typically it's harmless and doesn't require treatment. However, if you notice a foul odor to the discharge or a burning and itching sensation, you should contact your doctor. These could be signs of a yeast or bacterial infection.

 

Early Symptom of Pregnancy: Nausea (Morning Sickness)

The elevated levels of estrogen in your system can slow the emptying of your stomach. This contributes to another early symptom of pregnancy, nausea, or what many women call morning sickness. Not every woman gets morning sickness, and for many that do, morning sickness is a misnomer. The nauseous feeling can and often does occur at any time during the day.

Along with feeling nauseous, some women develop food aversions or food cravings when they become pregnant. These early pregnancy symptoms are also related to hormonal changes. The effect can be so strong that even the thought of what used to be a favorite food can turn your stomach.

Things other than pregnancy can cause these symptoms. For instance, a gastrointestinal upset or some other illness can be responsible for the nauseous feelings. A change in diet, stress, depression, or even being premenstrual may account for the cravings or food aversions.

It's possible that the nausea, cravings, and food aversions can last for the entire pregnancy. Fortunately, many women experience a lessening of the symptoms at about the 13th or 14th week. In the meantime, it's important to discuss your diet with your doctor to make sure that you and your developing baby get essential nutrients.

 

Early Symptom of Pregnancy: Breast Changes

Changes in your breasts are another very early sign of pregnancy. When you conceive, your body undergoes a rapid change in hormone levels. Because of the changes in hormones, you may notice in one to two weeks that your breasts have become swollen, sore, or tingly. Or they may feel heavier or fuller or feel tender to the touch. In addition, the area around the nipples, called the areola, may darken.

Pregnancy is not the only thing that can cause breast changes. A hormonal imbalance that's unrelated to pregnancy could be responsible. The changes could also be caused by a change in birth control pills, or they could be a premenstrual symptom.

If the changes are an early symptom of pregnancy, keep in mind that it is going to take your body several weeks to get used to the new levels of hormones. But when it does, your breasts will feel less painful than they do in the beginning.

Early Symptom of Pregnancy: Fatigue

 

Feeling unusually fatigued is an early pregnancy symptom that can occur as soon as one week after you conceive. The excessive tiredness is often related to a high level of progesterone in your system, although other things such as lower levels of blood sugar, lower blood pressure, and increased blood production can all contribute.

Fatigue not related to pregnancy can be caused by stress, physical exhaustion, depression, a common cold or flu, or other illnesses. If your fatigue is related to pregnancy, it's important to make sure you get plenty of rest; eating foods that are rich in protein and iron can help offset it.

Other Early Symptoms of Pregnancy

 

The altered balance of hormones in your body can cause multiple symptoms.

• Many women find frequent urination to be problem starting around the sixth or eighth week after conception. Although this could be caused by a urinary tract infection, diabetes, or excessive use of diuretics, if you're pregnant, it's most likely due to increased levels of hormones.
• The increased level of progesterone can also make you constipated. Progesterone causes food to pass more slowly through your intestines. Drinking plenty of water, exercising, and eating plenty of high-fiber foods can help offset this problem.
• Mood swings are common, especially during the first trimester. These are also related to changes in hormones.
• Many women report frequent mild headaches, and others experience chronic back pain.
• Dizziness and fainting may be related to dilating blood vessels, lower blood pressure, and lower blood sugar. Some women don't discover they're pregnant until they go to the doctor because of a fainting spell and are told that being pregnant is a possible explanation.

If you are pregnant, you could have all of these symptoms, or maybe have only one or two. But if any of these symptoms become bothersome, talk with your doctor about them. The doctor can help you find ways to offset them.