Pregnancy Guide

  • Week 4

    Sometime this week, you may be able to find out whether you're pregnant by a home pregnancy test.

    If the test is positive, call your selected practitioner's office and schedule your first prenatal appointment. Most practitioners may call off your visit to some weeks later; don’t be concerned and stop taking any medications.

    Inside pregnancy: Girl or boy?

    if yoif lsdkfjlsdkfjIf you have not already taken prenatal vitamins, it is necessary to use folic acid daily since the next weeks are very critical to your baby's development. Through the placenta, your baby is exposed to what you take into your body, so make sure it's good for both of you.
    If your home pregnancy test is negative, take another at the next days. Many urine tests are not sensitive enough to detect a pregnancy at four weeks.

    If you've tried to be conceived with no success for a year or more or six months if you're over 35, talk to your physician about a workup exam for you and your partner to spot possible fertility problems. While the results may be upsetting, finding out about a problem sooner rather than later will get you started on the road to treatment — and to your ultimate goal: having a baby.

  • week 5

    You may notice some pregnancy-related discomforts already. Many women report sore breasts, fatigue, and frequent urination starting in the early weeks. You may also have nausea, though it's more likely to show up in the coming weeks. They are all natural and may bother and harass you, but as a part of permanent events during pregnancy, they will not last forever.

    The outside world won't see any sign of the dramatic developments taking place inside you.

    You'll also want to continue or start an exercise routine. Exercise helps you develop the strength and endurance you'll need to manage the extra weight you'll be carrying. It may help prevent some of the aches and pains of pregnancy, and many women find that it's a great stress-reducer. Exercise can also help you get ready for the physical rigors of labor.

    Finally, it's easier to bounce back after you give birth if you've continued some form of exercise throughout pregnancy. Choose a safe, moderately vigorous activity you enjoy. Walking and swimming are fine choices for pregnant women.

  • Week 6

    You may find yourself developing a bit of a split personality — feeling moody one day and joyful the next. Unsettling as this is (especially if you pride yourself on being in control), what you're going through is normal. Ricocheting emotions are caused partly by fluctuating hormones. But hormones aside, your life is about to change in a big way — and who wouldn't feel emotional about that?

    Spotting (spots of blood on your underpants or toilet tissue after urinating) or bleeding is relatively common in early pregnancy. It may occur in a normal pregnancy, but sometimes it can be the first sign of miscarriage or an ectopic pregnancy. If you have any spotting or bleeding, call your physician.

  • Week 7

    You are in the first trimester of pregnancy and most women tolerate common chores of this period. Nausea in morning (which may take place day time) makes you to vomit. Nausea and vomiting during pregnancy is due to hormones disserted during this period. It’s suggested to put a biscuit beside your bed and eat it before getting up to prevent vomiting. (If you're feeling fine, don't worry — you're lucky!)

    You may need to pee more than usual, too, thanks to your increasing blood volume and the extra fluid being processed through your kidneys. It's unlikely, though, that the need to pee more than usual will ease up, but nausea will be decreased.

  • Week 8

    Although there may be no sensible increase in your weight, you may notice that your bra is getting snugger. Soon you'll likely need a larger size with better support. Your waist size will also be increased. The increase in your blood volume is another unclear change in your body. By the end of pregnancy, you'll have 40 to 45 percent more blood than you did before you were pregnant. So, you will need more iron. Take your daily vitamins to meet enough iron.

    Hormonal changes — in particular, a dramatic rise in progesterone — may be contributing to your sluggishness. Nausea and vomiting can certainly cost you energy, too. And you may be having trouble getting a good night's sleep at this point, especially if you're uncomfortable or find you need to get up to pee.

  • Week 9

    You still may not look pregnant even if your waist is thickening a bit. You probably feel pregnant, though. Not only are morning sickness and other physical symptoms out in full force for most women, but you may feel like an emotional pinball as well.

    Mood swings are common now — it's perfectly normal to feel alternately elated and terrified about becoming a mother. Try to cut yourself some slack. Most women find that moodiness flares up at around six to ten weeks, eases up in the second trimester, and then reappears as pregnancy winds to a close and may continue after the childbirth.

    You may find yourself bloating or passing gas more than usual. The primary reason is that you have much higher levels of progesterone, a hormone that relaxes smooth muscle tissue throughout your body, including your gastrointestinal tract. This relaxation slows down your digestion, which can lead to gas, bloating, burping, and flatulence and generally create miserable sensations in your gut, especially after a big meal.

  • Week 10

    Now your uterus doubles in size. Before you got pregnant, it was the size of a small pear. By this week, it's as big as a grapefruit. At your next prenatal visit, you may be able to hear your baby's rapid heartbeat with the help of a Doppler stethoscope. Many women say that the beating of their baby's tiny heart sounded like the thunder of galloping horses and hearing it for the first time was very moving.

  • week 11

    You may experience unusual complication during this period like excessive salvia. Learn which of your symptoms are normal and which ones are signs that something might be wrong. You're probably also wondering things like doing activities and using foods and medications. Find out what's safe and what's not during pregnancy. Don't worry if nausea has made it impossible for you to eat a wide variety of healthy foods or if you haven't put on much weight yet (most women gain just 1 to 2.5 kg during the first trimester). Your appetite will likely return soon and you'll start to gain about half kg a week.

  • week 12

    Your uterus has grown to the point where your healthcare provider can now feel the top of it (the fundus) low in your abdomen, just above your pubic bone. You may already be into maternity clothes, especially if this isn't your first pregnancy. If you're still fairly small and not yet ready for maternity clothes, you've no doubt noticed that your waist is thickening and that you're more comfortable in loose, less restrictive clothing.

    You may begin to feel heartburn (also called acid indigestion), a burning sensation that often extends from the bottom of your breastbone to your lower throat. Many women get heartburn for the first time during pregnancy, and those who've previously had bouts of heartburn may find that it gets worse. During pregnancy, hormonal and physiological changes cause this uncomfortable burning and sleeping sensation. Try to reduce your food volume and stay away from greasy and spicy foods to control this status.

  • Week 13

    Congratulations! This is the last week of your first trimester, and your risk of miscarriage is now much lower than earlier in pregnancy. Next week marks the beginning of your second trimester, a time of relative comfort for many women who see early pregnancy symptoms such as morning sickness and fatigue subside. But in some cases heartburn will be appeared. Birth is still months away, but your breasts may have already started making colostrum, the nutrient-rich fluid that feeds your baby for the first few days after birth, before your milk starts to flow. Many couples also notice a distinct libido lift around this time.

  • Week 14

    Following abatement and gradual disappearance of the early symptoms of pregnancy such as nausea, fatigue and chest pain, you will get more energy and have a pleasant feeling about the occurring changes to your body. The top of your uterus is a bit above your pubic bone, which may be enough to push your tummy out a tad. Starting to show can be quite a thrill, giving you and your partner visible evidence of the baby you've been waiting for. Take some time to plan, daydream, and enjoy this amazing time. It's normal to worry a bit now and then, but try to focus on taking care of yourself and your baby and having faith that you're well equipped for what's ahead.

  • week 15

    You've probably gained about 2 kg by now (a little more or less is fine, do not worried about your overweight). The amount of weight gained in pregnancies varies among women. Although you are well into the swing of your pregnancy, but you may still be surprised by an unexpected symptom now and then. If your nose is stuffed up, suppose it is also one of the pregnancy complications. You can probably chalk it up to the effect of increased estrogen that may lead to the swelling of the mucous membranes and cause the production of more mucus. Some pregnant women also suffer nosebleeds as a result of enhanced blood volume and blood vessel expansion in the nose. As pregnancy is often associated with changes in your immune system, and it will increase your risk of getting certain types of infections, you are more likely to get a cold or allergy. Anyway, you should avoid exposure to irritants such as cigarette smoke, dust and alcohol. Run a vaporizer or humidifier at night to help moisturize the nasal passages and drink plenty of fluids. You can use nasal saline drops or sodium chloride as well. If you don’t feel well, ask your doctor or midwife for advice about using a decongestant.

    Don't be surprised if you and your partner are feeling a little stressed out these days! Many couples worry about their baby's health and how they'll handle the changes ahead. But with physical discomforts on the wane and energy on the rise, this is also a wonderful trimester for most women.

  • Week 16

    Have your friends told how you look more attractive? Red cheeks (due to pregnancy) are a fact caused by increased blood flow to the skin surface. It's a wonderful time to enjoy once hormone levels stabilize and nausea reduces. Also, there’s no need to worry about the health of your child following the sharp reduction in the risk of miscarriage after week 14th. This is also another reason to have a sense of wellbeing! Soon, you’ll experience one of the most amazing moments of pregnancy — feeling your baby move. While some women notice "quickening" as early as 16 weeks, many don't feel their baby move until about 18 weeks or more. And if this is your first baby, don't be too impatient. You may not be aware of your baby's movements until 20 weeks or so. The earliest movements may feel like little flutters, gas bubbles, or even like popcorn popping. Over the following weeks, they'll grow stronger and you'll be able to feel them much more frequently.

  • Week 17

    As your belly grows, so you may begin to occasionally feel a little unsteady on your feet. Wear low-heeled shoes to reduce your risk of taking a tumble. Maybe for the first time this happened that you need to protect your stomach and it's very good. Trauma to your abdomen could be dangerous for you and your baby. You'll also want to be sure to buckle up when you're in a car. Keep the lap portion of the seat belt under your belly, drawn snugly across your hips. The seat belt should never pass on your belly, but it must be strapped low above and under your stomach.

  • Week 18

    Now, more comfortable clothes are a must as your appetite and waistline grow. Look for the maternity dresses fit your protuberant abdomen. No need to pay too much. Sometimes borrow them from friends and relatives, otherwise buy a dress that you can wear until the end of pregnancy or even afterwards. From now on, when you do lie down, it's best to lie on your left side. When you lie flat on your back, your uterus can compress a major vein, leading to decreased blood return to your heart. If you sleep on the left side, this pressure will fade away. Try placing a pillow behind you or under your hip or upper leg for comfort. Your cardiovascular system is undergoing dramatic changes, and during this trimester your blood pressure will probably be lower than usual. Don't spring up too fast from a lying or sitting position or you might feel a little dizzy. If you haven't already had a second-trimester ultrasound, you'll probably have one soon (usually 16 to 20 weeks). This painless procedure helps your practitioner to see how many babies you're carrying, check how your baby's growing, screen for certain birth defects, check the placenta and umbilical cord, and determine whether the due date you're working with is accurate. Bring your partner along, and be sure to ask for a printout for your baby's first photo album! Ask the tech beforehand whether you can take a camera or a tape recorder to save the ultrasound.

  • Week 19

    Only one week left to reach the half way mark. You may notice some achiness in your lower abdomen that may extend to the groin or even feel an occasional brief, stabbing pain on one or both sides , especially when you shift position or at the end of an active day. Most likely, this is round ligament pain. The ligaments that support your uterus are stretching to accommodate its increasing weight. This is nothing to be alarmed about, but call your practitioner if the pain continues even when you're resting or becomes severe. You may be noticing some skin changes, too. Are the palms of your hands red? Nothing to worry about. It's from the extra estrogen. You may also have patches of darkened skin that is normal in pregnancy. When these darkened patches emerge on your upper lip, cheeks, and forehead, they're called chloasma, or the "mask of pregnancy". Sometimes these patches are appeared on the arms or other parts exposed to sunlight. You may also notice some darkening of your nipples, freckles, scars, underarms, inner thighs, and vulva. That darkened line running from your belly button to your pubic bone is called the linea nigra, or "dark line”. The skin darkening and freckles are created due to a temporary increase in melanin (a substance that gives color to hair, skin and eyes). These darkened spots will probably fade shortly after delivery. In the meantime, protect yourself from the sun, which intensifies the pigment changes. Cover up, wear a brimmed hat, and use sunscreen when you're outdoors. And if you're self-conscious about your "mask," a little concealing makeup can work wonders. Avoid applying lightening creams without counseling. Some of them contain chemicals that are forbidden to use during pregnancy. In the future, you'll have enough time to improve your skin.

  • Week 20

    Congratulations! You've hit the halfway mark in your pregnancy. The top of your uterus is about level with your belly button, and you've likely gained around 4.5 kg. Expect to gain an average of 0.5 Kg per week from now on. If you started your pregnancy underweight, you may need to gain a bit more; if you were overweight, perhaps a bit less. Make sure you're getting enough iron, a mineral that's used primarily to make hemoglobin (the part of your red blood cells that carries oxygen). During pregnancy, your body needs more iron to keep up with your expanding blood volume, as well as for your growing baby and the placenta. Get iron-rich foods into your diet such as red meat, poultry, fish, egg, lentils and other legumes, spinach and iron-fortified cereals. If you haven't already signed up for a childbirth education class, you may want to look into one, especially if you're a first-timer. A structured class will help prepare you for the rigors of labor and delivery. These courses are organized, either as weekly meetings or as a single intensive, one-day session. Maybe your mom or partner can accompany you to antenatal classes. You should know that your baby is almost fully developed at 37 weeks, and you have to keep yourself prepared for his birth. So, plan to take necessary steps for preparing yourself.

  • Week 21

    You're probably feeling pretty comfortable these days. Your belly is not too big yet, and the usual discomforts associated with early pregnancy are, for the most part, gone. If you're feeling good, relax and enjoy it while you can. The third trimester may bring with it a new crop of complaints as your baby’s growth is almost complete. That's not to say you won't have some minor glitches to deal with now. For example, increased oil production may contribute to the development of acne in your skin. If that's the case, be diligent about washing well with a gentle soap or cleanser twice a day. Don't take any oral medications or use any topical products without first checking with your practitioner. You're also more prone to varicose veins now, particularly if your mother suffers from it. As your pregnancy progresses, there's increasing pressure on the veins in your legs. The blood volume increases and the uterus puts more pressure to the large vein (that carries blood from the lower half of the body to the heart). On the other hand, higher progesterone level cause the walls of your veins to relax and because of the growing fetus and uterus, the veins become larger and larger. Also, they tend to get worse with each successive pregnancy. Although the risk of injury is much greater in the leg veins, it may also appear in other areas such as the vulva. If you have foot pain, wear maternity support hose. A brisk walk daily will also help to improve blood circulation. Sleep on your left side and prop up your feet and legs whenever possible.

  • Week 22

    You may start to notice stretch marks on your abdomen as it expands to accommodate your growing baby. Some of pregnant women do not experience this condition, while at least half of them develop stretch marks on their skin. These small streaks of differently textured skin are appeared due to skin stretching and hormonal changes and can range from pink to dark brown (depending on your skin color). In addition, their thickness may increase with increasing gestational age. Although they most commonly appear on your tummy, stretch marks may also show up on your buttocks, thighs, hips, and breasts. There's no proof that lotion helps prevent stretch marks, but keeping your skin moisturized may help with any itching. Your innie belly button may also change shape and probably at first it becomes flat and taut against your skin, but it sticks out soon. Don’t worry! It will revert back to the normal appearance once your baby is born. Another skin change that may occur during pregnancy is developing of fairly large moles. In this situation, a small part of skin protrudes and becomes red and creates several appendages and blood vessels. This complication may involve the face, neck, upper chest and breasts due to increased estrogen levels in pregnancy and your skin goes back to normal after giving birth.

  • Week 23

    If you had headaches in your first trimester, you'll probably find that they diminish or even disappear during the second trimester. Changes in hormone levels and circulatory system or sinus congestion cause some women experience headaches in early pregnancy. You may notice that your ankles and feet start to swell a bit. This swelling may be the result of changes in your blood chemistry coupled with enlarging uterus. Changes in the chemical composition of the blood result in blood flow to the tissues. The enlarged uterus causes increased pressure on the veins returning blood from the extremities to the heart which can lead to poor circulation in your legs. The swelling tends to worsen by the end of the day or in the summer heat. Your body will get rid of the extra fluid after you have your baby, which is why you'll pee frequently and sweat a lot for a few days after delivery. In the meantime, lie down and put your feet up when you can, stretch out your legs when you sit, and avoid sitting in one place for long periods. Also, try to exercise regularly to increase circulation, and wear support stockings. You may be tempted to skimp on liquids, but you need to drink plenty of water to prevent your body swelling. Be sure to call your midwife or doctor if you have severe or sudden swelling of your face or hands. Excessive swelling may be a sign of a serious condition called preeclampsia.

  • Week 24

    In this week, the top of your uterus has risen above your belly button and is now about the size of a soccer ball. The skin of the abdomen and breasts has stretched which may lead to itchiness. If your skin is dry, keep it moist to avoid this complication. You may feel increased sensitivity to light, dry eye or something gritty in your eyes. This is a normal condition during pregnancy known as “dry eyes”. To improve this situation, you can use artificial tears to keep your eyes moist. Most women have a glucose screening test (also called a glucose challenge test or GCT) between now and 28 weeks. This test checks for gestational diabetes, a pregnancy-related high-blood-sugar condition. Untreated diabetes increases your risk of having a difficult vaginal delivery or needing a cesarean section because it causes your baby to grow too large, especially in his upper body. It also raises your baby's odds for other complications like low blood sugar right after birth. A positive result on your GCT doesn't mean you have gestational diabetes, but it does mean that you'll need to take the glucose tolerance test (GTT) to find out for sure. Finally, if you don't already know how to spot the signs of preterm labor, now's the time to learn. Contact your caregiver immediately in case you notice an increase in vaginal discharge (if it becomes watery, mucus-like, or bloody (even if it's pink or just tinged with blood)). In addition, call your midwife or doctor right away in the event of having any vaginal bleeding or spotting, abdominal pain or menstrual-like cramping that happen more than four times in one hour, an increase in pressure in the pelvic area or low back pain, especially if you didn't previously experience it.

  • Week 25

    Your baby's not the only one with more hair; your locks may look more full and lustrous than ever. It's not that you're growing more hair, but the hair that you'd normally shed is sticking around longer than usual. Also, your hair may appear darker and more noticeable. The extra hair will fall out after you give birth. Sometimes, you will have trouble to get rid of unwanted hair. You may also notice that you can't move around as gracefully as before. it's fine to continue to exercise, but don't work out when you're feeling overly tired and stop if you feel any pain, fatigue, dizziness, or shortness of breath. Don't lie flat on your back for long periods of time and avoid any exercise where you're apt to lose your balance. Be sure to drink plenty of water, and make time for both warm-up and cool-down periods. When you have your glucose-screening test at 24 to 28 weeks, a second tube of blood may be taken at the same time to check for anemia. Although your total blood volume increases significantly during pregnancy, the number of red blood cells may not increase enough. This complication is called the "physiological anemia of pregnancy which is most frequent in the second and third trimester. If blood tests show that you have iron-deficiency anemia , your caregiver will probably recommend that you take an iron supplement. Have you started thinking about baby names yet? Choosing a name is an important decision, but it should be a fun one, too. You may want to consider family history (Grandpa), favorite locations, or cherished literary or film characters. Check out a couple of baby-name books to help you brainstorm, too.

  • Week 26

    Around this time, your blood pressure, that tended to reach a low at about 22 to 24 weeks, may be increasing slightly to normalize as it would be. Preeclampsia most often shows up in the third trimester, so it's important to be aware of the warning signs. The disease occurs in 3 to 7 percent of pregnant women. This complication is marked by: sudden swelling of the hands and face, rapid weight gain (due to water retention), blurred vision, seeing spots or flashing lights, severe or persistent headache and intense pain or tenderness in your upper abdomen. To check your condition, your midwife and practitioner test your urine for protein, and measure your blood pressure at each prenatal visit. Anyway, call your caregiver immediately if you have any above symptoms. The early detection of disease is essential to keep you and your growing baby healthy. If your lower back seems a little achy lately, you can thank both hormonal changes that loosen your joints and ligaments and a shift in your center of gravity. Walking, standing, or sitting for long periods, as well as bending and lifting can all put a strain on your back. A warm bath or hot compress might bring relief. You may refer to a gynecologist to get prenatal massage. It is also a good option if you are aware of his competence. Use a pillow between your legs at bedtime to support your back and tummy. Try to maintain good posture during the day, to relieve pressure on your lower back. Be careful when bending or lifting objects. Contact your practitioner right away if you have severe pain or numbness in one of your limbs.

  • Week 27

    As your body gears up for the final lap, you may start noticing some new symptoms. Along with an aching back, you may find that your leg muscles cramp up now and then. They're carrying extra weight. Your expanding uterus needs more blood flow and is putting pressure on the veins that return blood from your legs to your heart as well as on the nerves leading from your trunk to your legs. Unfortunately, the cramps may get worse as your pregnancy progresses. Leg cramps are more common at night but can also happen during the day. When a cramp strikes, this exercise may help reduce your pain: Straighten your leg and then gently flex your toes back toward your shin. Next, return them back. This practice stretching the calf muscle should give you some relief. Walking for a few minutes or massaging your calf sometimes helps, too. It may be the furthest thing from your mind right now, but it's not too soon to think about family planning. You'll want to have made some decisions about postpartum birth control before your baby arrives. Maybe you decide not to have more kids! If you'd like the option of having the tubal ligation during your postpartum hospital stay, you have enough time at present to discuss it with your partner and caregiver.

  • Week 28

    You're in the home stretch! The third and final trimester starts this week and continues till the 40th week. If you're like most women, you'll gain about 0.5 kg per week this trimester. Around this time, do you feel an unpleasant "creepy-crawly" sensation in your legs? Itching and burning in the lower legs and irresistible urge to move them is known as restless legs syndrome (RLS). You cannot stop the movements while trying to relax or sleep. No one knows for sure what causes RLS, but it's relatively common among expectant mothers. Try to cut down on caffeine in tea or coffee, which can make the symptoms worse. Try stretching or massaging your legs when you have the problem. Some studies have shown that iron supplements can sometimes relieve RLS. From now on, you need to be checked by your doctor or midwife every two weeks. Then, at 36 weeks, you'll switch to weekly visits. If the blood test done at your first prenatal visit showed that you're Rh negative, you'll get an injection of Rh immunoglobulin to prevent your body from developing antibodies that could attack your baby's blood. If baby’s father is Rh negative too, there is no need for an injection of Rh immunoglobulin. However, most doctors give you a shot of immunoglobulin without receiving the father’s blood test. If your baby is Rh positive, you'll receive another shot of Rh immunoglobulin after you give birth. If you did not attend childbirth classes yet, it might be a good idea to have breathing exercises and relaxing at home. Childbirth is a long and tedious process. Also, it is very painful and if you are not prepared for it, you may have a difficult time. Many fathers are afraid of watching the birth scene. Maybe that's why nobody thinks about fathers’ participation in childbirth in Iran!

  • week 29

    Now, you can feel the movements of your baby. Pay attention to baby’s feet and elbow kicks. Let your doctor know if you ever notice that your baby is becoming less active. She may ask you to count the kicks and the movements of the baby to make sure that the baby is healthy.

    Some old friends like heartburn and constipation may take center stage now. The pregnancy hormone progesterone relaxes smooth muscle tissue throughout your body, including your gastrointestinal tract. This relaxation, coupled with the crowding in your abdomen, slows digestion. Sluggish digestion can cause gas and heartburn — especially after a big meal — and contribute to constipation. Your growing uterus and constipation may also be contributing to hemorrhoids. These swollen blood vessels in your rectal area are common during pregnancy. Fortunately, they usually clear up in the weeks after giving birth. If they're itchy or painful, try soaking in a sitz bath or applying cold compresses or warm water bags. Avoid sitting or standing for a long time. Talk with your doctor before using any remedies during pregnancy, and let your doctor know if you have any rectal bleeding. To prevent constipation, eat a high-fiber diet, drink plenty of water, and get some regular exercise.

    Some women get something called "supine hypotensive syndrome" during pregnancy. This happens when lying flat on your back causes a change in heart rate and blood pressure that makes you feel dizzy until you change position. You might notice that you feel lightheaded if you stand up too quickly. To avoid the problem, move slowly as you go from lying down to sitting and then standing.

  • week 30

    You may be feeling a little tired these days, especially if you're having trouble sleeping. You might also feel clumsier than normal, which is perfectly understandable. Not only are you heavier, but the concentration of weight in your body causes a shift in your center of gravity. Also, your ligaments are more lax. Also, this relaxation of your ligaments can actually cause your feet to spread permanently. Remember those mood swings you had earlier in pregnancy? The combination of uncomfortable symptoms and hormonal changes can result in a return of those emotional ups and downs related to early pregnancy. It's normal to worry about what your baby will be like or whether you'll be a good parent for him. Your concerns about the baby are all natural. But if you can't shake the blues or feel increasingly irritable or agitated, talk to your doctor or midwife. You may be among the 10 % expectant women who experience depression from mild to severe types during pregnancy.

  • week 31

    You may have noticed some leaking of colostrum, or "premilk," from your breasts lately. Some pregnant women may observe it or some may have not experience leakage of colostrum before the birth of the baby. Both cases are normal and they are the signs that your body is working properly. If there is a large amount of leakage, try tucking some nursing pads into your bra to protect your clothes. Moreover, if you plan to breastfeed, you might also want to pick up a nursing bra. If you are uncomfortable with your current bra, you can choose a nursing bra right now.

    Have you noticed the muscles in your uterus tightening now and then? Many women feel these random contractions — called Braxton Hicks contractions — in the second half of pregnancy. Often lasting about 30 to 60 seconds, they're irregular, and at this point, they should be infrequent and painless. The contractions are more frequent and sometimes painful during the final weeks of pregnancy. These contractions are often called “false labor pains”. Sometimes it is difficult to differentiate between true labor and false labor pains. However, before week 37th, your baby is still premature. Therefore, frequent contractions, on the other hand — even those that don't hurt — may be a sign of preterm labor. Call your doctor or midwife immediately if you have more than four contractions in an hour or any other signs of preterm labor such as an increase in vaginal discharge or a change in the type of discharge (if it becomes watery, mucus-like, or bloody — even if it's pink or just tinged with blood), abdominal pain or menstrual-like cramping, an increase in pressure in the pelvic area or low back pain, especially if you didn't have it before. If you're having a boy, it is better to take some time to think about when and how to have your baby circumcised. You can even consult with a gynecologist or pediatrician since there are different opinions about the appropriate time and method for circumcision.

  • week 32

    To accommodate you and your baby's growing needs, your blood volume has increased 40 to 50 percent since you got pregnant (blood plasma and red blood cells). The extra blood will compensate for bleeding during childbirth. You're gaining about 500 grams each week and roughly half of that goes right to your baby. With your uterus pushing up near your diaphragm and crowding your stomach, the consequences may be shortness of breath and heartburn. To help relieve your discomfort, try eating smaller meals more often (more than three meals a day) and prop up your feet and legs when sleeping. Smaller meals even reduce heartburn.

    Your abdominal weight gain shifts your center of gravity and changes your posture. Also it stretches out abdominal muscles. Hormonal changes in pregnancy loosen your ligaments and the expanding uterus puts pressure on some neurons. This results in a strain on your back, pelvic bones and your groin. If you feel numbness or tingling in your legs, you must inform your doctor or midwife.

  • week 33

    You may be feeling some achiness and even numbness in your fingers, wrists, and hands. Like many other tissues in your body, those in your wrist can retain fluid, which can increase pressure in the carpal tunnel, a bony canal in your wrist. Nerves that run through this "tunnel" may have pressure, creating problems such as numbness, tingling, shooting, burning pain or a dull ache. Try wearing a splint wrist or propping your arm up with a pillow when you sleep. If your work requires repetitive hand movements (at a keyboard or on an assembly line, for instance), remember to stretch your hands when you take breaks.

    If you have trouble sleeping at night, put a pillow between your legs and under your back. If this does not work, put several pillows under your head and try to sleep in half sitting position or try to sleep when sitting up in the bed and leaning on the pillows. When bathroom trips interrupt your sleeping, take smaller amounts of liquid from the evening onwards. For most women, sex during pregnancy is fine right up until their water breaks or their labor starts. However, it is recommended to use condom during the final weeks of pregnancy or avoid intercourse.

  • week 34

    By this week, fatigue has probably set in again which is quite understandable. Try to cut down on some of your activities and save energy for childbirth. If you spend a lot of time on your feet, try to use pregnancy belt; it protects your belly and distributes the weight evenly across your body. If you are sitting or lying down for a long time, get up slowly from your place because blood may be collected in your legs for a few moments, causes a temporary drop in blood pressure and dizziness when getting up.

    Most midwives offer pregnant women to have perineal massage (massaging the area between the vagina and anus) for preventing rupture of perineum during childbirth. Now it is a good time to do the massage. This massage may be uncomfortable for some women. This massage also does not necessarily prevent tearing of the perineum. However, in this case, ask your doctor and learn ways of doing it.

    If you notice itchy bumps or welts on your belly and possibly your thighs and buttocks as well, you may have a condition called pruritic urticarial papules and plaques of pregnancy, which is harmless. See your doctor in case of the problem to make sure it is not a serious problem. If you feel itchiness in your body, even if it is not intense, consult with your doctor.

  • week 35

    Your uterus is bigger than 15 times its original size and now reaches up under your rib cage and you conceive there is no space for its growing. If you could peek inside your womb, you'd see that there's more baby than amniotic fluid in there now. Your ballooning uterus is crowding your other internal organs, too, which is why you probably have to urinate more often and may be dealing with heartburn and other gastrointestinal distress. Your heart beats faster now. Even it is also difficult to breath and walk. If you're not grappling with these annoyances, you're one of the lucky few! This week, your weight is between 8 to 13 kgs more than the one in early pregnancy. In the final weeks, you may feel that the child is falling. You get the feeling since the baby’s head is inside your pelvic bone. Gradually you will be ready for delivery.

    From here on out, you'll start seeing your doctor every week. The doctor may also ask you to carefully monitor your baby's movements inside the womb to be sure the child is active. This is also a good time to create a birth plan. Use a form to write down all specifics — like who'll be present during your childbirth, what pain management techniques you want to try, and in which hospital you want to stay. It will give you a starting point to discuss your preferences with your medical team. Childbirth is unpredictable, and you probably won't be able to follow your plan to the letter, but thinking about your choices ahead of time and the possible events should take some of the anxiety out of the process.

  • week 36

    Now that your baby is taking up so much room, you may have trouble eating a normal-size meal. Smaller, more frequent meals are often easier to handle at this point. On the other hand, you may have less heartburn and have easier time breathing when your baby starts to "drop" down into your pelvis. This process often happens a few weeks before labor if this is your first baby. If your baby drops, you may also feel increased pressure in your lower abdomen, which may make walking increasingly uncomfortable. Some women say it feels as though they're carrying a bowling ball between their legs and it is likely that the ball falls out. But don’t worry. It does not fall out!

    You might also notice that your Braxton Hicks contractions are more frequent now. Call your doctor again and find out when you can have access to her at the time of labor and make the arrangements. As a general rule, you should call her when you have intermittent contractions, coming every five minutes for an hour. However, if you have not completed week 37 of pregnancy yet and you can see signs of preterm labor, you should immediately tell your doctor. Of course, you'll want to call right away if your amniotic sac ruptured (or think you're leaking amniotic fluid), or if you notice a decrease in your baby's activity, if you have any vaginal bleeding, fever, a severe or persistent headache, constant abdominal pain, or vision changes.

    Even if you're enjoying an uncomplicated pregnancy, it's best to avoid flying during your final month because you can go into labor at any time. In fact, some airlines won't let women on board who are due to deliver within 7 days (and sometimes even within 30 days) of the flight.

  • week 37

    In the coming weeks, you just have to wait. From now on, you can prepare baby supplies and do the things that you may not be able to do after the birth. Take a nap or read whenever possible. Have your sleep and dreams changed recently? When you sleep, do you think your dreams are real? If so, do not be surprised! Anxiety about becoming a parent can fuel a lot of strange flights of unconscious fancy.

    Braxton Hicks contractions may be coming more frequently now and may last longer and be more uncomfortable. When the incidence of these contractions becomes more frequent, you may think that it is the time for delivery. You might also notice an increase in vaginal discharge. During pregnancy, dense and thick mucus blocks the cervix and it has a protective role. When labor is near, cervical mucus plug becomes bloody and it is removed with the opening of the cervix. The condition is called “bloody show” and if you see the condition, labor is probably near. Call your doctor immediately in case of spotting or bleeding like the conditions during your pregnancy.

  • week 38

    It may be harder than ever to sleep well at night. If you can, take it easy through the day — this may be your last chance to do so for quite a while. Keep monitoring your baby's movements, too. Though the space around the baby becomes tight, he should still be as active as before. Some swelling in the feet is normal during these last weeks, but call your doctor or midwife without delay if you notice excessive or sudden swelling of your feet or hands, or have a sudden weight gain. Also let her know immediately if you have severe or persistent headaches, blurred vision, seeing spots or flashing lights or intense upper abdominal pain. These are symptoms of a serious condition called preeclampsia. Encourage your partner to relax and do the things he loves, since after the birth, there would be no time for fun.

  • week 39

    At each of your visits, your doctor or midwife will do an abdominal exam to check your baby's growth and position. She might also do an internal exam to see whether your cervix has started effacing (cervix thinning out) or dilating (cervix opening). If your baby still shows no signs of appearing after successive weeks, do not panic! Only 5% of babies are born on the due date. Your baby can't stay inside you forever! If you go past your due date, your doctor or midwife will schedule you for a sonogram after 40 weeks to ensure that it's safe to continue the pregnancy. If you don't go into labor on your own, most doctors will induce labor (by use of serum) when you're between one and two weeks overdue (after 40 weeks).

    You may have heard that pregnant woman water has broken in a busy place without any labor pain! If this happens for you, do not panic. Membranes rupture takes place in 15 % of pregnancy cases before the labor pain. Sometimes there's not a big gush of fluid, there's only a small gush or a slow leak. Call your midwife or doctor even if you only suspect you have a leak or the water is broken. Try to be calm since the labor pain starts in a few hours. It is better to consult with your doctor or midwife about these conditions. You may be told to stay at home until you have regular contractions with short intervals or go to the hospital for injection of antibiotics. If labor contractions do not start after breaking of water, labor induction can be used. Also if you see that the baby is a little slow or inactive, even if there is no leaking, call your doctor immediately.

    There are other signs that indicate the time of pregnancy and they are more common than broken water. You may notice thick, dense and pink mucus in your undies in the toilet. The condition is called bloody show and indicates that labor is probably a few days away — or less. Usually the labor pain starts one or two days after bloody show. In case of spotting or vaginal bleeding, call your doctor immediately. Another sign for labor can be regular contractions and gradually, the intervals tend to be shorter. If you have experienced Braxton Hicks contractions before, now you understand they were simple practices! Your doctor or midwife would tell you when to call her. If some contractions start that each lasts for more than one minute or they occur every five minutes and last continuously for one hour, it is time for going to the hospital. Now, you should measure the time between the contractions. If you are not sure it is the labor time or not, call your doctor. Your doctor may ask you to count your babies movements. If even the doctor does not ask you to count the movements, in case of a severe increase or decrease in baby movements, call your doctor immediately. Your baby should be active until labor and his lack of activity is the sign of a problem in pregnancy; maybe delivery needs to be done quickly.

  • week 40

    Despite all medical advances, there is no way to estimate the exact time of delivery. It may also happen before the due date especially when you misestimated the conception date. However, this may happen if you're relying solely on a due date calculated from the day of your last period and you had no sonogram during your first trimester. Even with reliable dating, some women have prolonged pregnancies for no apparent reason. You still have a couple of weeks before you'll be considered "post-term." After about one or two weeks, you would be considered late term. But to be sure whether your baby is still thriving, your doctor will schedule you for testing in this week or the beginning of week 41st to keep an eye on your baby if your pregnancy continues. If you observed these symptoms before, it is better to start the tests earlier.

    You may have a biophysical profile (BPP), which consists of an ultrasound to look at your baby's overall movements, breathing movements, and muscle tone (natural stretch of muscles, whether he opens and closes his hand or extends and then flexes his limbs), as well as the amount of amniotic fluid that surrounds him (important because it's a reflection of how well the placenta is supporting your baby). Fetal heart rate monitoring for 20 minutes will generally be done as well — by itself or as part of the BPP. It consists of evaluating the baby’s heart rate by a specific device and an ultrasound to assess the amount of amniotic fluid. The tests are usually done twice a week. If the fetal testing isn't reassuring — the amniotic fluid level is too low, for example — you'll be induced. Your doctor will also check your cervix to see if it's "ripening." Its position, how effaced (thinned out) it is, and how dilated (open) it is can all affect when and how your labor is induced. If you don't go into labor on your own, you'll be induced, usually sometime between 41 and 42 weeks.

  • Department of International Patients

    Avicenna Fertility Center has set up International Patient Affairs Department to provide high quality services for the convenience of clients abroad. Those who intend to enjoy these services could refer to this department on the second floor to get informed of the conditions in details

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