Pregnancy
Basic Information

Pregnancy

This document provides an overview of pregnancy; the reproductive process through which a new baby is conceived, incubated and ultimately born into the world. Many facets of pregnancy are covered starting with the preparation and planning stages, and moving through conception, fetal development, labor and delivery, and post-partum (or post-birth) stages. The document describes normal, uncomplicated pregnancy in some detail, and also contains information concerning more difficult pregnancies, including pregnancies for women with chronic illnesses and other health complications.

Pregnancy is a unique, exciting and often joyous time in a woman's life, as it highlights the woman's amazing creative and nurturing powers while providing a bridge to the future. Pregnancy comes with some cost, however, for a pregnant woman needs also to be a responsible woman so as to best support the health of her future child. The growing fetus (the term used to denote the baby-to-be prior to birth...

 
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What are the basics of conception and how can I plan for a pregnancy?

  • A pregnancy occurs when reproductive cells from a man and a woman's body become combined inside a woman's uterus.
  • The normal way that this occurs is through sexual intercourse, where the man's penis enters the woman's vagina and ejaculates sperm (the male reproductive cells) into the vagina during the process of orgasm or sexual climax.
  • Though intercourse is the normal method through which an egg and a sperm get together, modern reproductive medicine has opened up new possibilities.
  • Despite the incredible fertility of some women, most women find that it takes a little effort to get pregnant.
  • The timing of that intercourse must be just right so that sperm and egg get to meet, there must be no significant obstacles that would prevent the sperm from reaching the egg, and the sperm and egg must be must both be of good-enough quality.
  • Having made the decision to become pregnant, there are a few things you can do to increase your likelihood of conceiving including predicting the best time of the month to try to become pregnant, with natural planning and over-the-counter options.

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What are the symptoms of pregnancy and how is it diagnosed?

  • For most women, the first signs of pregnancy are a missed period, breast fullness, breast tenderness, nausea, frequent headaches, and fatigue.
  • While some symptoms of pregnancy can occur as soon as one week after conception, the same symptoms can also indicate other non-pregnancy related conditions.
  • Once you have determined that your symptoms are not caused by illness, you may want to use a home pregnancy test to confirm that you are pregnant.
  • Although most tests claim to be able to detect pregnancy as soon as the first day of your missed period, you will obtain a more accurate result by waiting to take the test until 7 days after the day you expected your period to occur.
  • Although home pregnancy test results are generally accurate, they aren't as definitive as the blood test for pregnancy that your doctor can administer.
  • You should ask your doctor to perform a blood test a week after your missed period if you suspect you may be pregnant despite a negative home pregnancy test result, or if you want positive confirmation as to whether you are pregnant or not.

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What are common tests used during pregnancy?

  • Beginning with your first prenatal visit to your doctor, you may be asked to undergo various tests to monitor your health and the health of your developing baby.
  • Some of these tests are capable of detecting genetic or developmental problems in the fetus.
  • The following are some of the tests that are commonly performed during pregnancy.
  • The Triple Screen Test (or Triple Marker) is a blood test capable of determining whether or not your baby may be at risk for birth defects, such as Spina Bifida, or chromosomal abnormalities, such as Down Syndrome (a common form of mental retardation).
  • The Nuchal Translucency Screening Test, also known as the nuchal fold scan, uses ultrasound to measure the translucency, or clear space, at the back of the developing fetus's neck.
  • In Amniocentesis, a sample of the amniotic fluid that surrounds the fetus while it develops inside its mother is collected and analyzed so as to learn about the baby's genetic development or to check for infection.
  • Chorionic Villus Sampling (CVS) is another technique for testing the fetus' genetic development. CVS involves the removal of placental tissue and is generally recommended for the same reasons as Amniocentesis, and carries many of the same risks of associated miscarriage. It can be performed earlier than the Amniocentesis (between 10 and 12 weeks of gestation), and it offers better than 99% accuracy in detecting many genetic disorders and chromosomal abnormalities.
  • You should consider your age, your previous medical history, and the medical history of your family when deciding whether or not to go forward with genetic testing during your pregnancy.
  • Additionally, it is important to consider what positive results (indicating problems) would mean for you and your family.
  • Discuss the options and risks associated with each of these tests with your doctor to decide which might be important for you.

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What are the stages of pregnancy?

  • Pregnancy lasts about nine calendar months (about 40 weeks total). It is typically broken down into three "trimesters" or stages of fetal development.
  • The first trimester of pregnancy lasts from conception until 12 weeks gestation (pregnancy length) and during the first trimester, the growing baby is developing at an amazing rate.
  • The Second Trimester lasts from weeks 13-27, and for many women, this is the most comfortable trimester, and a good time to prepare yourself and your home for the arrival of the new baby.
  • The final stage of pregnancy, weeks 28 through 40, is often marked by excited expectation of the baby's arrival.

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How can I plan for labor and what pain management options can I use?

  • Labor is the process through which a pregnancy ends and a baby is born.
  • It is a good idea that you establish a plan for labor and delivery well in advance of your due date.
  • The first decision you need to make when thinking about the birth of your baby is where you would feel most comfortable delivering.
  • You'll also need to start thinking about who you want to be present throughout your labor and the delivery of your baby.
  • Another choice you will need to make in preparation for labor is whether or not you want to use pain medication.
  • In preparing for a delivery, you may choose to take relaxation and breathing technique classes, or to do exercises to help strengthen the muscles you will use during labor.
  • It is important to educate yourself about your options for pain management during labor, and to decide which methods will best fit your needs.
  • There are various methods, some common and some lesser-known that can help reduce pain during labor including the Lamaze technique, the Bradley Method, Acupuncture, Transcutaneous Electric Nerve Stimulation (TENS), massage, warm water tub, sedative medications, narcotic medications, and regional anesthesia (commonly called an epidural).

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What are the stages of labor?

  • The labor process has three stages.
  • Contractions occur during the first stage of labor, resulting in the opening (dilation) of your cervix (the opening between the vagina and the uterus).
  • This first stage usually lasts several hours, and has three phases.
  • "Active labor" (phase two) begins when the cervix reaches 3 to 4 cm in diameter. Contractions usually become stronger, more regular, and more frequent during this phase, and the cervix begins to dilate faster as well.
  • The third phase of stage one labor is called "transition". During transition, the cervix dilates to between 7 and 10 centimeters. This is often the most difficult phase, but it is also the shortest in duration.
  • The second stage of labor occurs when the baby moves through the birth canal and is delivered into the world. This stage typically lasts between 20 minutes and two hours.
  • The third and final labor stage occurs when the placenta (the sac of blood vessels that accompanied the baby in the uterus) is delivered. This final stage begins immediately after the birth of your baby, and continues until the placenta is removed from your body. The process is typically fairly brief, lasting between 5 and 30 minutes in duration.

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What are post-partum issues that can occur and decisions that need to be made?

  • The weeks and months that follow after the initial excitement of the new baby's birth can be an emotion roller coaster for new mothers.
  • Many women experience the "baby blues", a mild form of depression that lasts one week to ten days after the baby is born.
  • However, for some women (especially young moms) these blues can become more severe and long-term and are then called Postpartum depression, which can occur anytime within six months of giving birth, and if left untreated, can last longer than one year.
  • One difficult decision you may face during your pregnancy is deciding whether or not to breastfeed your newborn baby.
  • There are several options available to you should you choose to bank (save) your baby's cord blood and you should speak to your doctor about the various pros and cons regarding chord blood banking.

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What medical conditions can complicate pregnancy or require special care?

  • Not every woman who gets pregnant is necessarily healthy or young.
  • When medical conditions exist prior to pregnancy, doctors will need to modify prenatal care recommendations.
  • These conditions include:
    • Hyperthyroidism
    • Hypothyroidism
    • Diabetes mellitus
    • Lupus
    • Herpes
    • AIDS
    • Heart Disease
    • Paralysis
    • Obesity

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