| Pregnancy
		
			| Topic OverviewIs this topic for you? This topic covers pregnancy information, including planning for labor and delivery. If you aren't pregnant yet, see the topic Preparing for a Healthy Pregnancy.   For more information on labor and delivery, see the topic
			 Labor and Delivery.  What can you do to have a healthy pregnancy? You may be happy and
			 excited to find out that you're pregnant. And you may be a little nervous or worried. If this will be your first
			 child, you may even feel overwhelmed by all of the things you need to know
			 about having a baby. There is a lot to learn. But you don't have to know
			 everything right away. You can read all about pregnancy now, or you can learn
			 about each stage as your pregnancy goes on. Pregnancy is measured in
		  trimesters from the first day of your last menstrual
		  period, totaling 40 weeks. But a full-term
		  pregnancy can deliver between 37 weeks and 42 weeks. During your pregnancy,
			 you'll have tests to watch for certain problems that could occur. With all the
			 tests you'll have, you may worry that something will go wrong. But most women
			 have healthy pregnancies. If there is a problem, these tests can find it early
			 so that you and your doctor or midwife can treat it or watch it to help improve
			 your chance of having a healthy baby.  Taking great care of
			 yourself is the best thing you can do for yourself and your baby. Everything
			 healthy that you do for your body helps your growing baby. Rest when you need
			 it, eat well,  and exercise regularly. Drink plenty of
			 water before, during, and after you are active. This is very important when
			 it's hot out. You'll need to have
			 regular checkups. At every visit, your doctor or midwife will weigh you and
			 measure your belly to check your baby's growth. You'll also get blood and urine
			 tests and have your blood pressure checked. It's important to avoid
			 tobacco smoke, alcohol and drugs, chemicals, and radiation (like X-rays). These
			 can harm you and the baby. What kinds of exams and tests will you have?Your
			 first prenatal exam gives your doctor or midwife important information for
			 planning your care. You'll have a pelvic exam and urine and blood tests. You'll
			 also have your blood pressure and weight checked. The urine and blood tests are
			 used for a pregnancy test and to tell whether you have low iron levels (are
			 anemic) or have signs of infection. At
			 each prenatal visit you'll be weighed, have your belly measured, and have your
			 blood pressure and urine checked. Go to all your appointments. Although these
			 quick office visits may seem simple and routine, your doctor is watching for
			 signs of possible problems like
			 high blood pressure. In some medical
			 centers, you can have screening in your first
			 trimester to see if your baby has a chance of having
			 Down syndrome or another genetic problem. The test
			 usually includes a blood test and an
			 ultrasound.  During your second trimester,
			 you can have a blood test (triple or quadruple screen test) to see if you have
			 a higher-than-normal chance of having a baby with birth defects. Based on the
			 results of the tests, you may be referred to a geneticist for further
			 discussion. Or you may have other tests to find out for sure if your baby has a
			 birth defect.  Late in your second trimester, your blood sugar
			 will be checked for diabetes during pregnancy (gestational diabetes). Near the end of your pregnancy, you will have tests to look
			 for infections that could harm your newborn. What changes can you expect in your body and your emotions?You will go through some amazing changes during pregnancy. Your body, emotions, and relationships will all do some growing.  These changes are common, but some may be a challenge. Every woman feels these changes in her own way. Even the way she changes can change. In the beginning of your pregnancy, you may feel so tired that you can barely keep your head up. But at other times, you may have trouble sleeping. Many women feel nauseated in the morning (morning sickness) or at other times of day in the early part of pregnancy. But some women never have this problem. Your breasts will get larger and may feel tender. Throughout your pregnancy, you may get heartburn or crave certain foods, and you may have aches and pains. You also may enjoy the flutters of your baby moving and kicking. Your emotions may move around too. Even women who are happy about their pregnancy may worry a lot about their babies. They may even feel some sadness at the coming changes in their lifestyles.  Your relationship with your partner and other children you may have also may change. Talk with your partner and with your doctor if you have concerns about how you're feeling. Frequently Asked Questions| Learning about pregnancy: |  |  | Interactive tools: |  |  | Decisions: |  |  | Special concerns: |  | 
Prenatal Visits and TestsThe first test you may have is the one you take at home to see if you're pregnant. After you know you're pregnant, you will have a series of  tests throughout your pregnancy to make sure you and your baby are healthy. At-home pregnancy test If you think you might be
		  pregnant, you can use a
		  home pregnancy test as soon as you think you have missed your period.  Pregnancy is measured in
		  weeks from the first day of your last menstrual period. There are several methods to
		  find out your due date. Use this Interactive Tool: What Is Your Due Date? Checkups and tests after you know you're pregnantAs soon as you
		  know you're pregnant, make an appointment with your doctor or certified
		  midwife. Your first prenatal visit will provide information that
		  can be used to check for any problems as your pregnancy progresses. It's also a good time to think about how you want to partner with your doctor or midwife.  Good care during pregnancy includes
		  regularly scheduled prenatal exams. At each prenatal
		  visit, you'll be weighed, have your abdomen measured, and have your blood
		  pressure and urine checked. Use this time to discuss with your doctor or midwife your list of pregnancy
		  concerns or problems.  At different times in your
		  pregnancy, you may have additional exams and tests performed. Although some
		  are routine, others are only done when you ask for them, when a problem is suspected, or if you have a
		  risk factor for a problem.Testing For Birth DefectsTests in the first and second trimester can show if your baby has a birth defect. It's your choice whether to have these tests. You and your partner can talk to your
			 doctor or midwife about  birth defects tests.  To learn more about these tests, see the topic Birth Defects Testing.  You
			 can choose from different kinds of tests. If you are worried about the chance of a birth defect, you might want test results as early as possible. If your risk for having
			 a baby with a birth defect is very low or  if knowing that your baby has a birth defect wouldn't change your plans, you might decide not to have early tests. Or you might choose not to have these tests at all. Pregnancy: Should I Have Screening Tests for Birth Defects?
Health and NutritionThe best way to help yourself have a healthy pregnancy is to eat well,
			 exercise regularly, get plenty of rest, and avoid things that could hurt  your baby.   For more tips on how to have a healthy pregnancy, see Quick Tips: Healthy Pregnancy Habits. Eat wellTry to  get proper nutrition. Pay close attention to your folic acid, iron, and calcium
				intake and the need for slow, gradual weight gain.   Women who are obese have a different weight-gain goal than other women.A vegetarian diet requires special
				attention so that you get enough
				protein,
				vitamin B12,
				vitamin D, and zinc, in addition to the extra
				folic acid, iron, and
				calcium that all expectant mothers need. These
				nutrients are vital to your fetus's cellular growth, brain and organ
				development, and weight gain.Calcium is an important nutrient, especially during
				pregnancy. If you can't or don't eat dairy products, you can get calcium in
				your diet from
				nonmilk sources such as tofu, broccoli, fortified
				orange juice or soy milk, greens, and almonds. 
 To learn more about eating well, see: Healthy Eating: Changing Your Eating Habits.Healthy Eating: Making Healthy Choices When You Shop. Healthy Eating: Cutting Unhealthy Fats From Your Diet.Quick Tips: Adding Fruits and Vegetables to Your Diet.
 Stay activeExercise during pregnancy can help your body best handle labor, delivery,
				and recovery.
				Moderate activity such as brisk walking or swimming is ideal
				during pregnancy. Some women enjoy prenatal yoga. Drink plenty of water before, during, and after you are
				active. This is very important when it's hot out.Fitness: Walking for Wellness
Do pelvic floor (Kegel) exercises  during and after pregnancy. They
			 strengthen your lower pelvic muscles. They may help prevent
			 urine control problems (incontinence) after childbirth. In addition to moderate exercise, the following stretching and
			 strengthening exercises are well suited to pregnancy:
 What to avoidMedicines that are not approved by your doctor or midwifeAlcohol and drugsTobacco smokeSources of food poisoning that may cause listeriosis
				or toxoplasmosis infection, such as raw meat, poultry, or seafood;
				unwashed fruits or vegetables; and cat feces or outdoor soil that cats commonly
				useRaw (unpasteurized) milk and cheeses made with raw milkFish that contain high levels of mercury, such as shark, swordfish, king mackerel, marlin, orange roughy, bigeye tuna, or 
				tilefish from the Gulf of Mexico.Hazardous chemicals, radiation, and certain cosmetic productsCaffeine (or limit your intake to 1 cup of coffee or
				tea each day)Things that raise your core body temperature, such as doing hot yoga or using hot tubs and saunas
 What's okay when you're pregnantSex causes no problems during an uncomplicated
				pregnancy, and sexual interest often changes during different phases of a
				pregnancy. Working or going to school, if it isn't too physically
				demanding, is usually fine during pregnancy. Scale back if you're becoming too
				worn down as your pregnancy progresses. Talk to your doctor or midwife if
				you are at risk for
				preterm labor. Travel is usually a safe choice until later pregnancy.
				Talk to your doctor or midwife if you have any concerns. During your third
				trimester, it's best to stay within a few hours of a hospital, in case of
				sudden changes that need medical attention. Wearing a seat belt is vital to protect yourself and your baby during pregnancy.
				Massage during pregnancy is safe when it is done by a
				specially trained massage therapist. 
Body ChangesPregnancy is a time of many changes. Your body will go through a lot on the way to creating a new person. Normal physical changes and symptoms throughout pregnancyAlthough they
			 can range from mild to severe, the following conditions are common during
			 pregnancy: Many pregnant women also have: First trimesterThe first trimester of pregnancy lasts from week 1
		  through week 12. Your first sign of
			 pregnancy may be a missed menstrual period. Other early signs of pregnancy,
			 caused by hormonal changes, include: Second trimester The second
		  trimester of pregnancy (from week 13 to week 27) is the time when most women start to look pregnant and may begin to wear maternity clothes. By 16 weeks, the top of your uterus,
		  called the fundus, will be about halfway between your pubic bone and your
		  navel. By 27 weeks, the fundus will be about
		  2 in. (5 cm) or more above your
		  navel.   You may find that the second trimester is the easiest part of
		  pregnancy. For some women, the breast tenderness,
		  morning sickness, and fatigue of the first trimester
		  ease up or disappear during the second trimester, while the physical
		  discomforts of late pregnancy have yet to start. Pressure on your bladder may
		  be less as the uterus grows up out of the pelvis.  Common symptoms you may experience during the second trimester of pregnancy
		  include:  Third trimesterThe third trimester lasts from week 28 to the birth. Many women have some discomfort during this time as their belly gets bigger. You might have trouble getting comfortable so you can sleep. And you might have a few other aches and pains. Common symptoms you may experience during the third trimester 
		  include: Braxton Hicks contractions, which are "warm-up"
			 contractions that do not thin and open the cervix (do not lead to labor).
			 Fatigue. Back pain. Pelvic ache and hip pain. Hemorrhoids and constipation. Heartburn (a symptom of
			 gastroesophageal reflux disease, or GERD). Hand pain, numbness, or weakness (carpal tunnel syndrome).Breathing difficulty, since your uterus is now just below your
			 rib cage, and your lungs have less room to expand.Mild swelling of your feet and ankles (edema). Pregnancy causes
			 more fluid to build up in your body. This, plus the extra pressure that your
			 uterus places on your legs, can lead to swelling in your feet and
			 ankles.Difficulty sleeping and finding a comfortable
			 position. Lying on your back interferes with blood circulation, and lying on
			 your stomach isn't possible. Sleep on your side, using pillows to support your
			 belly and between your knees. Later in your pregnancy, it is best to lie on
			 your left side. When you lie on your right side or on your back, the increasing
			 weight of your uterus can partly block the large blood vessel in front of your
			 backbone. Frequent urination, caused by your enlarged uterus and the
			 pressure of the fetus's head on your bladder.
Baby Development Pregnancy is measured in
		  trimesters from the first day of your last menstrual
		  period, totaling 40 weeks. The first trimester of pregnancy is week 1
		  through week 12, or about 3 months. The second
		  trimester is week 13 to week 27. And the third
		  trimester of pregnancy spans from week 28 to the
		  birth.  Your baby will change from week to week.  To learn more about how your baby is
			 changing each month and about what tests you might think about having, see the
			 Interactive Tool: From Embryo to Baby in 9 Months. First trimester During the week after
			 fertilization, the fertilized egg grows into a microscopic ball of cells
			 (blastocyst), which
			 implants on the wall of your uterus. This implantation
			 triggers a series of hormonal and physical changes in your body.  
			 The third through eighth weeks of growth are called the embryonic stage, during
			 which the
			 embryo develops most major body organs. During this
			 process, the embryo is especially vulnerable to damaging substances, such as
			 alcohol, radiation, and infectious diseases.   Having reached a
			 little more than 1 in. (2.5 cm) in length by the ninth week of growth, the embryo is called a
			 fetus. By now, the uterus has grown from about the
			 size of a fist to about the size of a grapefruit.  The first trimester is a time of amazing development. The embryo starts out looking like a tiny seed, then a tadpole with a tail, and then more human. Second trimesterIf this is your
		  first pregnancy, you'll begin to feel your fetus move at about 18 to 22 weeks
		  after your last menstrual period. Although your fetus has been moving for
		  several weeks, the movements have not been strong enough for you to notice
		  until now. At first, fetal movements can be so gentle that you may not be sure
		  what you are feeling.  If you've been pregnant before, you may notice movement
		  earlier, sometime between weeks 16 and 18. During this time, the fetus is still building up body fat and starting to put on a lot of weight.
By the end of the second trimester,
		  your fetus is about
		  10 in. (25.5 cm) long and
		  weighs about 1.5 lb (680 g). Third trimester The third
		  trimester of pregnancy spans from week 28 to the
		  birth. Although your due date marks the end of your 40th week, a full-term
		  pregnancy can deliver between week 37 and week 42. During this
		  final trimester, your fetus grows larger and the body organs mature. The fetus
		  moves frequently, especially between the 27th and 32nd weeks.  After week 32, a fetus becomes too big to move around easily
		  inside the uterus and may seem to move less. At the end of the third trimester,
		  a fetus usually settles into a head-down position in the uterus. You will
		  likely feel some discomfort as you get close to delivery.Emotions and RelationshipsThe emotional experience of pregnancy is different for
		  every woman. It's common to have mixed emotions and to feel uncertain-even if your pregnancy was
		  planned.  Because of the increasing hormones and the fatigue of
		  early pregnancy, mood swings can be worse than before pregnancy. Many women
		  worry that their baby will  have a problem. Or they may feel anxious about childbirth. Your relationships with family and friends may change as  you adjust to having a new family member. With all the changes in your life, you may feel stressed at times. Try relaxation exercises and use time management tips and skills at home. Stress Management: Doing Guided Imagery to RelaxStress Management: Breathing Exercises for RelaxationStress Management: Managing Your Time
Health ConcernsSome women have health problems or concerns before they get pregnant.  For other women, problems may come up during pregnancy. Your doctor or midwife will work with you to prevent or  manage these problems to help you have a healthy pregnancy. If you have a health problem or concern, you may have a high-risk pregnancy. This means that your doctor or midwife needs to follow you closely. It doesn't mean that something will go wrong during your pregnancy. Pregnancy when you have health problemsCommon infections during pregnancy Vaginal yeast infections are more common in pregnancy
				because of the increased levels of hormones. Call your doctor or midwife if
				you have
				symptoms of a vaginal yeast infection or bacterial
				vaginal infection (bacterial vaginosis). Urinary tract infection is common during pregnancy and
				must be treated with antibiotics to prevent a dangerous infection or preterm
				labor. Bacterial vaginosis (BV) that causes symptoms is
				usually treated with oral antibiotics. Some women carry group B strep bacteria in their vaginal area. A woman can pass this infection to her baby during vaginal birth. This infection doesn't cause symptoms, but you will be screened for it in your third trimester.
 Health problems that can happen during pregnancyOther concerns during pregnancySmoking during pregnancy increases the risk of  problems such as low birth weight, preterm labor, and miscarriage.Pregnancy over age 35 poses some risks, but most older
			 women have healthy pregnancies. Medicine use (including herbal remedies) during pregnancy should always be approved by your doctor or midwife, to
				prevent harm to the fetus. Immunizations help protect you and your baby from certain health problems. The flu vaccine and the tetanus, diphtheria, and pertussis (Tdap) vaccine are recommended for all pregnant women. It is safe to get these vaccines during your pregnancy. You may need to get other vaccines before or soon after your pregnancy.Pregnancy after bariatric surgery may mean that you keep seeing the doctor who did your weight-loss surgery, along with seeing the doctor or midwife who is caring for you during pregnancy.Domestic violence can happen more often and/or get worse when women are pregnant. It is dangerous for both the mother and the baby. For more information and to learn how to get help, see the topic Domestic Violence.
Planning for Labor During your
		  prenatal visits, talk with your doctor or midwife about what you would like
		  to happen during your labor. Consider writing up your labor and delivery
		  preferences in a birthing plan, either in a
		  childbirth education class or on your own. You can
		  find examples of birthing plans on parenting websites.  Because no labor or delivery can be fully anticipated or planned in
		  advance, be flexible. Your experience after labor begins may be totally
		  different from what you expected. If an emergency or an urgent situation
		  arises, your plans may be changed for your own or your baby's safety.   When making plans for your baby's birth, consider the
		  location of your delivery,
		  who will deliver your baby, and whether you want
		  continuous labor support from a
		  doula, a friend, or family members. If you haven't
		  already, this is also a good time to decide whether you'll attend a
		  childbirth education class, starting in your sixth or
		  seventh month of pregnancy.  Learn about labor and delivery ahead of time. Think
		  through your preferences for comfort measures, pain relief, medical procedures,
		  and fetal monitoring. And think through how you want to handle your first hours with your
		  newborn. To learn more, see the topic Labor and Delivery. Planning  to breastfeedPlan ahead for breastfeeding by learning about breastfeeding and finding a
			 good
			 lactation consultant ahead of time and buying necessary
			 supplies. To learn more,
			 see the topic Breastfeeding. Breastfeeding: Planning Ahead
 Cord blood bankingSometime during your pregnancy, you may get information about cord blood banking. Cord blood is the blood left in the umbilical cord after birth. Think about whether you want to bank your baby's umbilical cord blood for possible future use.  Pregnancy: Should I Bank My Baby's Umbilical Cord Blood?
When to Call a DoctorAt any time during pregnancyAt any time during your pregnancy,
		  call your doctor or midwife immediately if you:  Have signs of
			 preeclampsia, a potentially life-threatening
			 condition, such as: 
			 Sudden swelling of your face, hands, or feet.Visual problems (such as dimness or blurring).Severe headache.
Have pain, cramping, or fever with bleeding from the
			 vagina.Pass some tissue from the uterus. Think or know you have a fever.Vomit more than 3 times a day or are too nauseated to eat or
			 drink, especially if you also have fever or pain. Have an increase or gush of fluid from your vagina. It is
			 possible to mistake a leak of
			 amniotic fluid for a problem with bladder control.
			 
 At any time during your pregnancy,
		  call your doctor or midwife today if you:  Notice sudden swelling of your face, hands, or feet. Have any vaginal bleeding or an increase
			 in your usual amount of vaginal discharge. Have pelvic pain that doesn't get better or go away.Have itching all over your body (usually in the evenings at
			 first, then throughout the day as well) with or without dark urine, pale
			 stools, or yellowing of skin or eyes.Have painful or frequent urination or urine that is cloudy,
			 foul-smelling, or bloody.Feel unusually weak.
 Between 20 and 37 weeks If you are between 20 and 37 weeks
		  pregnant, call  911  or other emergency services immediately if you:  Experience severe vaginal bleeding.Have severe abdominal (belly) pain.Are in your third trimester and have had fluid gushing or leaking from your vagina (the
			 amniotic sac has ruptured) AND
			 you know or think the umbilical cord is bulging into your vagina (cord
			 prolapse). If this happens, immediately get down on your knees so your buttocks
			 are higher than your head to decrease pressure on the cord until help arrives.
			 Cord prolapse can cut off the fetus's blood supply. (These measures apply to
			 you if you are as early as 24 weeks pregnant.) 
  If you are between 20 and 37 weeks
		  pregnant, call your doctor or midwife immediately or go to the hospital if you:  Have signs of
		  preterm labor, including: Mild or menstrual-like cramping with or without diarrhea. Regular contractions for an hour. This means about 4 or more in
			 20 minutes, or about 8 or more in 1 hour, even after you have had a glass of
			 water and are resting.Unexplained low back pain or pelvic pressure.
 Have noticed that your baby has stopped moving or is moving much
			 less than normal. See
			 Pregnancy: Kick Counts for information on how to
			 check your baby's activity. Have uterine tenderness or unexplained fever (possible symptoms
			 of infection).
 After 37 weeksAfter 37 weeks, call  911  or other emergency services immediately if you:   Have had fluid gushing or leaking from your vagina (the
			 amniotic sac has ruptured) AND
			 you know or think the umbilical cord is bulging into your vagina (cord
			 prolapse). If this happens, immediately get down on your knees so your buttocks
			 are higher than your head to decrease pressure on the cord until help arrives.
			 Cord prolapse can cut off the fetus's blood supply. (These measures apply to
			 you if you are as early as 24 weeks pregnant.) 
 After 37 weeks of pregnancy,
		  call your doctor or midwife immediately or go the hospital if you:  Have vaginal bleeding (for light spotting, you can call at any
			 time on the same day). Have had regular contractions for an hour. This means about 4 or
			 more in 20 minutes, or about 8 or more within 1 hour. Have a sudden release of fluid from the vagina. Notice that the baby has stopped moving or is moving much less
			 than normal. See
			 Pregnancy: Kick Counts for information on how to
			 check your baby's activity. 
  To learn more about problems during pregnancy,
		  see the topic
		  Pregnancy-Related Problems. Other Places To Get HelpOrganizationsAmerican Congress of Obstetricians and Gynecologists
		(ACOG) www.acog.orgU.S. Department of Health and Human Services:  Women's Health www.hrsa.gov/womenshealth/index.htmlReferencesOther Works ConsultedAmerican College of Obstetricians and Gynecologists (2010). Your Pregnancy and Birth, 5th ed. Washington, DC: American College of Obstetricians and Gynecologists. American College of Obstetricians and Gynecologists (2012). Update on immunization and pregnancy: Tetanus, diphtheria, and pertussis vaccination. ACOG Committee Opinion No. 521. Obstetrics and Gynecology, 119(3): 690-691.U.S. Department of Health and Human Services, U.S. Environmental Protection Agency (2011). Mercury Levels in Commercial Fish and Shellfish. Available online: http://www.fda.gov/Food/FoodSafety/Product-SpecificInformation/Seafood/FoodbornePathogensContaminants/Methylmercury/ucm115644.htm.
CreditsByHealthwise StaffPrimary Medical ReviewerSarah Marshall, MD - Family Medicine
 Kathleen Romito, MD - Family Medicine
 Adam Husney, MD - Family Medicine
 Elizabeth T. Russo, MD - Internal Medicine
 Specialist Medical ReviewerKirtly Jones, MD - Obstetrics and Gynecology
Current as ofJune 12, 2017Current as of:
                June 12, 2017 Last modified on: 8 September 2017  |  |