Baby’s Growth & Development
Near the end of the first trimester (13 weeks gestation) your baby is about
three inches long. It weighs about one ounce. The brain and spinal cord are developing rapidly. Your baby can squint, frown, open and shut its mouth, turn its head, make a fist, and kick.
The placenta has formed and blood is now circulating through the umbilical cord. Amniotic fluid cushions the baby and allows the baby to move around easily. At this time, you cannot feel these movements.
The baby’s heartbeat may be heard as early as the twelfth week of pregnancy using a highly sensitive Doppler (ultrasound) device that allows us to hear the baby’s heart. The normal range for the baby’s heart rate is 115 to 160 beats per minute. Fast or slow, the heart rate is not a valid indication of whether a baby is a girl or a boy.
Childbirth Preparation Classes
We strongly recommend that you and your partner take classes that will help prepare you for childbirth and parenting.
Childbirth education teaches the expectant couple about the mother’s bodily changes and the process of giving birth. Instructors usually discuss medical procedures such as electronic fetal monitoring, pain medications and other medications which may be used during labor and delivery, difficult labor and birth, and cesarean delivery. Also, breastfeeding and infant care classes are highly recommended. Plan ahead to take these classes in the early 3rd trimester (after 28 weeks), as classes often fill up early.
Fatigue is a natural occurrence in pregnancy; it results from the hormonal and other physiological changes in your body.
Also, anemia may cause fatigue and point out the need for increased iron intake.
Pregnancy places many demands on your body, and it is normal to often feel tired. It is important to get both regular exercise and enough rest at night. Exercise helps you maintain a healthy weight and flexibility, it stimulates circulation and also combats fatigue and depressed mood. It is not unusual to find your energy returning as you move through the middle months of pregnancy.
Eat about 300 calories above what you usually eat. Healthy foods such as fresh fruits, vegetables and whole grains are
great. Stay away from fast foods; they are too high in fats and salt. Limit your caffeine intake. Increase your calcium intake to 1500mg per day.
Stay away from unpasteurized cheese and dairy, undercooked meat, and fish with high levels of mercury (shark, swordfish, tilefish, and king mackerel).
Medications I can take during pregnancy
Often pregnant women need to know what over the counter medications they can take for cough or colds. The less
medication you take while you are pregnant the better. If you have a cold and need some relief, it is safe to take Sudafed (pseudoephedrine, not phenylephrine, which is the new over the counter version) or Actifed (one or the other - not both at the same time), Robutussin, Vicks 44 and throat lozenges as directed on the package.
Do not take aspirin, Motrin, Aleve or Advil while pregnant; you can take Tylenol and Extra-Strength Tylenol (acetaminophen). Any time you are sick, be sure to drink plenty of fluids, at least eight glasses of water per day.
If you have diarrhea, you can take Kaopectate or Imodium, although it is often better to let diarrhea run its course without medications.
If you have heartburn, you may take Tums, Maalox, etc.; liquid antacids usually work better than tablets. Tums is also a good calcium supplement.
Call your provider if you have a fever over 100.4, a productive cough, or worsening symptoms. Take Tylenol to keep your fever down.
Morning Sickness
Nausea and vomiting are common complaints during the first 3 months of pregnancy and are usually due to hormonal
changes occurring in your body. About half of all pregnant women experience this problem. Nausea may start about the sixth or seventh week, but seldom continues beyond the end of the third month.
Although, often called morning sickness, nausea and vomiting may occur at anytime of the day. If vomiting is severe and you are not able to keep fluids down for 24 hours, report it to your doctor. Never take prescription drugs, over-the-counter medicines, or at home remedy unless recommended by your doctor.
You may find some relief by eating dry cereal, a piece of toast, or a cracker about a half hour before getting out of bed in the morning. Move slowly when you get up. Let plenty of fresh air into the house to get rid of cooking and other household odors. You may take a half a Unisom and 50mg of vitamin B6 every six hours.
Divide your food into five small meals a day rather than three large ones, since keeping food in your stomach seems to control nausea. Avoid greasy and highly spiced foods or any food that disagrees with you. Drinking liquids between meals instead of with your food may help.
Pregnancy can be an emotional roller coaster for some women; mood swings, irritability, irrational thoughts, and
tearfulness are not unusual. It is also common to feel disorganized and to have trouble concentrating. Accept your feelings and share them with someone who cares. Talk to your provider if you are troubled by how you feel emotionally.
Exercise During Pregnancy
Mild to moderate physical activity is beneficial to a pregnant woman and will not harm the baby. Women who have not
exercised regularly before becoming pregnant should not now begin a vigorous exercise program (high impact aerobics, cycling, jogging, etc.), but may do some low-key exercising. The following important points should be considered when you reflect on the benefits of regular exercise during pregnancy:• If you have some complications during your pregnancy you will probably be advised not to exercise. Talk to your pro- • Begin and end exercise with a warm up and cool down time. • Avoid exercising in hot weather. Be sure to drink plenty of fluid. • Monitor your level of exertion - moderate to moderately hard is fine; avoid hard or extreme levels of exertion. Stop if you feel dizzy, faint, short of breath, or significant cramping.
After 20 weeks gestation, do not exercise while lying flat on your back; and to avoid dizziness, rise slowly from lying on your side to the standing position.
Nasal congestion, fatigue, eyestrain, caffeine withdrawal, anxiety, and tension are all possible causes of headaches during
pregnancy (and other times). Rest and relaxation are often the most effective remedies for headaches. For headaches of the sinus type, press a hot, moist towel over your eyes and forehead. If nasal congestion is part of the problem, a humidifier or hot shower may help. A decongestant may also be helpful.
You may take plain or extra-strength Tylenol for headaches. Do not take aspirin, Motrin, Aleve or Advil. If headache persists or is accompanied by changes in vision, right upper quadrant pain, swelling of face and or hands, notify your provider immediately. Pregnancy is not the time to have new glasses or contact lenses fitted, and the lenses that were fine before you became pregnant might cause headache or strain now. Your body’s increased volume of circulation during pregnancy can affect your vision, but be reassured that these problems are only temporary.
Hot Tubs
Hot tubs are best avoided in pregnancy.
The Vancouver Clinic does not advocate smoking, drinking, or other drug use during pregnancy.
Weeks Gestation: ___________________Weight: ___________________________ The goal of our obstetricians and nurse midwives is to provide you with the best prenatal care possible.


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