Pregnancy and Childbirth

Overview

A woman is considered pregnant when she has a growing fetus in her uterus. Most women discover that they are pregnant when they miss one or more consecutive periods. As well, many women experience such symptoms as nausea or vomiting (known as morning sickness), sore breasts, mood swings, food cravings or aversions, and frequent urination.

Pre-pregnancy

Pre-pregnancy, or preconception care, includes basic healthcare with additional counseling about what to expect once you have conceived and steps you can take to prepare your body for pregnancy and ensure a healthy pregnancy. Preconception care is also called prenatal care, a term that includes care up to the baby’s birth. Topics you and your healthcare provider will discuss include nutrition, physical activity, and basic skills for caring for your newborn.

Steps you can take to prepare your body for a healthy pregnancy include:

  • Take folic acid. The U.S. Public Health Service recommends that women of childbearing age get at least 400 micrograms of folic acid daily. Folic acid is contained in certain foods and in supplements. Folic acid supplements are often recommended to women three months before getting pregnant and for at least the first three months of pregnancy.
  • Get your immunizations. If you’re thinking about getting pregnant, get vaccinatedbefore you get pregnant for diseases that could harm the fetus. These include chicken pox and rubella.
  • Make sure any medical conditions are under control.
  • Be healthy! Maintain a healthy weight, eat a well-balanced diet, and get regular physical activity. These behaviors will help keep you and your fetus healthy during pregnancy. As well, avoid smoking, alcohol, and drugs.
  • Avoid harmful exposures. Some prescription, over-the-counter medications, and herbs and supplements can be harmful to the fetus—ask your healthcare provider about these and also about environmental exposures (certain cleaning products, for example) that you should avoid.

If you’re in your thirties or forties…

Fertility declines with age, but many, if not most, women in their late thirties and early forties have healthy babies. At this stage in life, however, you may need to pay extra attention to how you prepare your body for pregnancy. See your doctor regularly before you start trying to conceive—he or she can help you prepare.

 

When Should I Stop Taking Birth Control?

It is usually recommended that women who want to get pregnant stop taking birth control pills three months before they start trying to conceive. Condoms can be used for birth control during these three months.

Fertility Problems

Women of childbearing age who cannot get pregnant after one year of trying and men who cannot impregnate a woman after one year of trying are considered infertile. As well, the term infertile is used to describe women who can get pregnant but cannot carry a pregnancy to term, or birth.

What causes infertility?

There is no single cause of infertility, but several factors may contribute. And because becoming pregnant requires that several steps—from release of a healthy egg from the ovaries to nurturing a growing fetus—are carried out successfully, a complication with any of these steps can lead to infertility.

Genetic conditions and other health problems—gynecological and general—can cause infertility, and environmental factors can also contribute. Gynecologic causes of infertility may include: blocked fallopian tubes due to endometriosis, pelvic inflammatory disease, or surgery; problems with the uterine wall; and uterine fibroids.

Problems with ovulation are often the cause of infertility. Ovulation can be affected when the ovaries stop functioning before natural menopause (premature ovarian failure), by polycystic ovarian syndrome (PCOS)—a condition where an egg is not released regularly or is not viable and healthy—and other conditions. Polycystic ovarian syndrome can also affect a woman’s uterus, making it impossible for the fertilized egg to be implanted.

Lifestyle and environmental factors that can raise a woman’s risk of infertility include:

  • Age
  • Stress
  • Poor diet
  • Being overweight or underweight
  • Smoking, drugs, and alcohol
  • Environmental toxins
  • Genetic conditions
  • Other health problems, such as sexually transmitted diseases

Infertility can be diagnosed by a healthcare provider. For some couples, infertility is treatable, often with both medical approaches and lifestyle changes.

Exams and Testing

Testing for Pregnancy

Testing for pregnancy can be performed at home or in your doctor’s office. In both settings, tests work by detecting a hormone in the urine or blood that is present only during pregnancy. This hormone is called human chorionic gonadotropin (hCG) and is made when a fertilized egg implants in the uterus—about six days after the sperm and egg merge. Blood tests are performed by your doctor, and urine tests can be done at home or at the doctor’s office.

Tests and Exams During Pregnancy

Regular visits to the doctor throughout pregnancy (prenatal care) will monitor your health and your baby’s. Early appointments will include checking blood pressure, taking urine samples, and measuring uterine size, as well as weighing the mother and checking the fetal heart rate.

Different tests and exams are performed as pregnancy evolves; for example, amniocentesis, a test to rule out certain defects including Down syndrome, can be performed during the second trimester, as can ultrasound, which determines the baby’s sex. As a mother’s due date approaches during the third trimester, exams will begin to focus on progress toward labor, with internal and external exams that check the baby’s size and determine if he or she has dropped into the correct position for birth.

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