Common Questions About Pregnancy

How is the baby's due date calculated?

The gestation period or length of pregnancy is about 282 days. To determine your due date, use the first day of your last menstrual cycle, subtract three months and add seven days. For example, if your last menstrual cycle was June 1, subtracting three months will bring you to March 1. Then adding seven days will make your due date March 8.

The date of conception may also be used to estimate your due date. This can be hard to calculate with irregular periods or after you stop taking birth control pills because of the wide variation in ovulation onset; or periods with little bleeding or spotty bleeding with pregnancy that can be mistaken as menstruation. Ovulation normally occurs 12 to 16 days after the onset of menses. Fertilization occurs within 12 hours of ovulation. An ultrasound can be used very early in a pregnancy to estimate the size of the embryo, which will give a more accurate assessment of age of gestation.

What happens to the mother-to-be during each trimester?

The pregnancy is divided into three trimesters. The first trimester ends after 14 weeks, the second ends after 26 weeks and the third at term (about 40 weeks).

The first trimester is the time when the first period is missed, which is often the first sign or symptom of pregnancy. Breast tenderness, especially around the nipple, is also common during the first trimester. By the end of the second month, the breast size and blood flow increases. Most women experience fatigue, which is thought to be caused by hormonal changes. Many women will have nausea and/or vomiting. Initially many women will also experience an increased frequency in urination. This is related to the pressure on the bladder from the growing uterus. hese symptoms are very normal. There are many changes that are occurring as the new pregnancy develops. Your blood pressure and blood sugar becomes lower, hormonal and metabolic changes are occuring. Your cardiac volume (the amount of blood that is in the heart) and cardiac output (the amount of blood the heart pumps out to the body) also is altered due to increased blood flow requirements to the uterus. Normally. you will not gain much weight during the first three months.

During the second trimester there will be big changes in the mother's appearance. The uterus moves into the abdominal cavity. With this move the broad ligaments (which extend from the uterus on each side, to the pelvic wall) stretch and may lead to low, sharp painful sensations. Contractions may be felt during the second trimester and are usually irregular and painless. The vaginal and pelvic tissues have increased blood flow, which can lead to heightened arousal and sexual interest for some. For others, there is a diminished sexual interest due to fatigue, hormonal changes, breast tenderness, self-consciousness about their changing body, and fear that sex may be harmful for the baby (which is usually not true). Leukorrhea, a thick, white vaginal discharge, is common as well. Breasts become more nodular. The line from the pubic bone to the belly button, called the linea alba, becomes darkened and more distinct and is now called the linea nigra. Spider veins and stretch marks begin to appear at this time. ,The gums have a tendency to become soft and swollen and may bleed more easily. For this reason good dental care is very important. Heartburn or esophageal regurgitation can become more pronounced at this time. Your heart rate will go up slightly but your blood pressure will go down. It is very important to take your vitamins and you may need to add an iron supplement, as well. Fetal movements are normally first felt at 16-20 weeks' gestation. You are at a slightly increased risk for urinary tract infections, so be sure and wipe front to back, increase your fluid intake, and call your physician if symptoms develop. A urinary tract infection can increase your risk of preterm labor. Because of the growth of the fetus during these months you have an increased need for protein and carbohydrate intake. Be sure and eat a well-balanced diet. Weight gain should be steady during the second trimester.

In the third trimester, the mother may feel discomfort, have increased swelling (especially in the lower extremities) and have an increase in varicose veins due to her swelling abdomen. Back pain may become more pronounced during this time as well. As the uterus grows, the lower back curves inward. This is called lordosis. It occurs due to the need to keep the center of gravity stable with the growing size of the uterus. However, due to the lordosis there may be compensatory positioning of the neck and shoulders. This neck and shoulder position may also cause aching, weakness, and/or numbness of the arms. The corpus luteum (hormone secreting structure on the ovary that forms at the sight where the egg was released), placenta and lining of the uterus will secrete relaxin. Relaxin is a hormone that loosens the ligaments that hold joints in place. These joints are beginning to loosen in preparation for childbirth. This can contribute to an unsteady gait and joint achiness.

What happens to the unborn baby during pregnancy?

Fetal age is usually referred to by weeks of gestation. The baby is referred to as an embryo until the end of the eighth week of gestation. Afterward, the developing baby is called a fetus. This term continues to apply until birth. During the embryonic period, all major organs and systems of the body have begun to form. This is the most critical period of development. By the end of this period, the external appearance of the embryo has an unquestionably human appearance. The fetal period is concerned with rapid growth and differentiation of tissues and organs that had started to develop during the embryonic period. At four weeks of development, the embryo is about the size of an apple seed. The neural tube, which will become the brain, spinal cord/nerves and backbone, are developing. The heart and circulatory system also begin to appear. During week five the limb buds begin to form. These limb buds become the baby's arms and legs. Facial features are also beginning to form. At six weeks, the hands and feet look like paddles and the heart is beating 100 – 130 beats per minute. At seven weeks, the embryo is about the size of a grape. The teeth and palate are forming, as well as the ears. The fetal heart movement can be seen on ultrasound by 6-8 weeks' gestation. Fetal heart tones can be heard by ultrasound at approximately 8-10 weeks' gestation. By week nine the fingers and toes are clearly visible. At this time, all the organs, nerves, and muscles are beginning to function. At 10 weeks the fetus is active. He/she is swallowing and kicking (even though mom will probably not feel this activity). The head is approximately half the size of the entire fetus. By the end of the first trimester the fetus has all its parts -- including tooth buds, fingernails, and toenails -- and is kicking and stretching. The baby's critical development has now been completed and the risk of miscarriage drops considerably. The baby is about 3 inches long and weighs approximately a half-ounce. His/her face looks more human. Nerve cells have been developing rapidly and the fetus will respond to touch with reflexive movement like curling the fingers or toes when the palm or sole is touched.

By week 14, the fetus is approximately 3.5 inches long, and weighs 1.5 ounces. As the eyes develop, the lids are fused (unable to be opened) until around 27 weeks' gestation. The second trimester is a time when the baby grows and body systems mature. The body becomes covered with a fine hair called lanugo. This hair will disappear closer to term. Eyebrows and the hair on top of the head are starting to grow now. About this time, the baby can be seen frowning and grimacing and the baby may be seen on ultrasound sucking his/her thumb. The baby also begins to grasp things it comes in contact with, such as the umbilical cord. Even though the sex of the baby was determined at conception, you may not be able to identify the sex organs until week 15. Fetal movement is felt between 16 and 20 weeks' gestation. Usually, first-time mothers feel movement later than mothers who have had a past pregnancy. Ligaments on each side of your uterus and pelvic walls (called broad ligaments) are stretching as your baby grows, so it's normal to feel some slight pain in your sides. Your baby is going through a tremendous growth spurt. Between weeks 16 and 20, the baby will double in weight and grow in length. The skeleton is made of soft cartilage (similar to the tip of your nose) but will begin to become firmer. By 20 weeks the baby is swallowing amniotic fluid and the kidneys are functioning well at making urine, which keeps the amniotic fluid at a constant amount. At 20 weeks, a cheesy, white substance called vernix caseosa begins to encase the baby and protects the skin while the fetus is immersed in amniotic fluid. By 23 weeks, the fetus' hearing is well established and he/she is able to recognize your voice, beating heart and rumbling stomach.

At 27 weeks, the baby weighs about 2 pounds and is 13 inches long. The eyes open and close and the baby is developing a regular sleep cycle. By 30 weeks, the baby grows more slowly in length but continues to gain weight. Fetuses at this age will follow a light shown on the abdomen and may even reach out for it. By 32 weeks, the baby weighs approximately 3.75 pounds and is about 16.5 inches long. The lungs are not fully developed until closer to week 40, but the fetus is inhaling amniotic fluid to practice breathing and to exercise his/her lungs. By 35 weeks there is less amniotic fluid and more baby. You may be able to identify body parts from outside your abdomen as the baby moves and stretches. The baby weighs about 5.25 pounds and is about 18 inches long. At 36 weeks, the baby continues to put on weight. This will provide him or her with a layer of fat that helps maintain body temperature after birth. At this age they will be gaining approximately an ounce a day. By 37 weeks, the downy, fine lanugo and most of the vernix caseosa have disappeared. As the baby drinks the amniotic fluid, he or she also drinks in the lanugo and vernix caseosa, which have been shed. This matter will be stored, along with other secretions, in the bowels and will become the baby's first bowel movement. This first bowel movement is called meconium, and is a blackish, green, sticky waste product. The average full-term baby weighs between 6 and 8.5 pounds and is 20 to 22 inches long. The lungs are one of the last systems to mature. Even at full term, it can take some babies a few hours to establish a normal breathing pattern.

When is fetal movement first felt?

Fetal movement, also referred to as "quickening," is commonly felt by the mother at 16 to 20 weeks' gestation. Mothers who are pregnant for the first time feel movement later than in subsequent pregnancies. The baby is moving much earlier than this, which can be seen on ultrasound, but the mother does not feel the movement until the baby is a little bigger and the baby's bones have become harder. Early fetal movement is normally felt when the mother is sitting or lying quietly. The initial feelings are like a tickle or feathery feeling below the belly button. As the baby grows, the movements become stronger, more regular and easier to feel. Sometime (usually starting in your seventh month) your doctor may encourage you to count the number of times your baby moves. You should feel him or her move at least five times in an hour. To count, lie down on your side. If you haven't eaten or had a drink for a few hours, do so before counting. If the baby has fewer than 10 movements in two hours, call your health care provider or go to the hospital.

Should I visit the dentist when I am pregnant?

Dental care during pregnancy is a very important part of keeping yourself healthy. Be sure to let your dentist know that you are pregnant when you visit. Unless absolutely necessary, X-rays should be avoided during pregnancy. If X-rays are needed, use a lead shield to cover your abdomen. There is research that suggests periodontal disease may be linked to or have an association with preterm labor and the delivery of a low birthweight baby. One theory is that the bacteria associated with gum disease produces a hormone that is thought to begin contractions. Something as simple as good oral hygiene may have an impact on reducing premature birth rate.

You may have heard that pregnancy can cause tooth loss. This is a myth. Your gums will naturally become more swollen and may bleed more easily with brushing while you are pregnant. This is partly due to hormonal changes associated with your pregnancy. However, good oral care, including keeping regular checkup appointments with your dentist, are the way to maintain good oral health. It is recommended that dental treatment take place during the second trimester, if possible. The first trimester is the time that most organs and systems of the baby are developing. Any dental care during that time should be limited to decrease any potential risk to the fetus and its developing organs. During the third trimester, as your uterus enlarges, it becomes more uncomfortable to lie back in the dental chair. However, if you have a toothache, it is unlikely to go away without professional interventions.

To help prevent tooth decay and periodontal disease, brush your teeth thoroughly twice a day with a fluoride toothpaste to remove plaque. Plaque is an invisible, sticky layer of harmful bacteria that constantly forms on teeth. The bacteria converts sugar and starch that remain in the mouth after eating into acid that attacks tooth enamel. This acid attack on the enamel is what can eventually lead to tooth decay. Be sure to clean between your teeth daily with floss or interdental cleaners to remove food particles as well.

Epulis gravidarum is a type of gingivitis that can occur during pregnancy. This is an overgrowth of the gum tissue. It is characterized by small, benign tumors (sometimes called pregnancy tumors) on the gums. These "pregnancy tumors" are characterized by red, raw-looking mulberry-like surface that bleeds easily. They are usually removed after the baby is born.

If you notice any oral health issues or changes in your gums, be sure and see your dentist and/or health care provider.

What foods should I avoid during pregnancy?

Alcohol: All alcohol should be avoided during pregnancy. Fetal alcohol syndrome has been reported with very small amounts of alcohol intake during pregnancy. FAS is preventable but not treatable. This means there is no cure. Consequences of FAS include developmental delays and smaller babies. Alcohol consumption also can have significant effects on the baby's nervous system. FAS can affect the day-to-day functioning of the child at school and with peers, including intellectual and behavioral issues. Later in pregnancy, alcohol may increase the risk of preterm delivery.

Foods that can contain listeriosis: Listeriosis is an infection caused by a bacteria called Listeria monocytogenes, which can cause fetal damage or miscarriage. The bacteria will give the mother mild to moderate gastrointestinal illness with nausea, vomiting and diarrhea. The American College of Obstetrics and Gynecology recommends that pregnant women should not consume unpasteurized milk or soft cheeses; cold cut meats; or undercooked or raw animal foods, such as meat fish, shellfish, or eggs. Also, all fresh fruits and vegetables should be washed thoroughly before being consumed. Other recommendations include: no hot dogs or deli meats (including ham, turkey, salami, bologna) unless they are reheated until steaming hot; avoid soft cheeses such as feta, brie, camembert, Roquefort, blue-veined or Mexican-style (hard cheeses, processed cheeses, and cream and cottage cheeses are safe); avoid refrigerated pates or meat spreads (Listeria thrives at refrigerator temperatures); avoid smoked seafood.

Foods that can contain salmonella and escherichia coli: These are bacteria that cause food poisoning. Foods to avoid include raw vegetables; unpasteurized juices; liver ;and undercooked meat, poultry or eggs. Thorough cooking kills bacteria and the proper temperature can be determined by using a meat thermometer. Guidelines for meats include cooking ground beef to a temperature of 160 degrees, roasts and steaks to 145 degrees, and whole poultry to 180 degrees Fahrenheit. Eggs should be cooked until they have a firm yolk and whites. Avoid any foods that may contain raw or partially cooked eggs, including eggnog and hollandaise sauce. All raw fruits and vegetables should be washed thoroughly before eating.

Food that can contain mercury: The Food and Drug Administration advises pregnant or nursing women against eat shark, swordfish, king mackerel, or tilefish. However, the FDA says nursing and pregnant women can eat up to 12 ounces of cooked fish per week if they eat smaller fish and a variety of fish. All fish contain trace amounts of mercury that they absorb from industrial pollution in the water. Larger fish that are older in age have higher mercury levels and cause more concern for consumption by pregnant women. The Environmental Protection Agency also recommends that pregnant women and young children limit the intake of freshwater fish caught recreationally in freshwater lakes and rivers to no more than one meal per week. They also advise observation of all local advisories about fish consumption.

Sodium: Americans consume, on average, large quantities of sodium (salt). Pregnant women should remember that processed and pre-prepared foods are high in sodium. Eating large quantities can contribute to water retention and swelling. Sodium use does not need to be restricted, but it should not be used excessively.

What foods should I eat during pregnancy?

Good nutrition is of the utmost importance during pregnancy. Good nutrition will help maintain maternal energy requirements, provide the building materials necessary for fetal growth, and help build energy reserves that the mother will needs after the baby is born and for milk production. Energy requirements of a pregnant woman are 17 percent higher compared to a woman who is not pregnant, so a pregnant woman needs to increase her calories. A woman of normal weight should consume approximately 300 extra calories a day. The average daily intake recommended for pregnancy is 2500 calories per day. Protein should make up 20 percent of the diet, fats 30 percent, and carbohydrates the remaining 50 percent. A sample diet for pregnancy follows the food pyramid and should include:

6-11 servings of grains or breads.
3-5 servings of vegetables.
2-4 servings of fruit.
4-6 servings of dairy/milk.
3-4 servings of meats, beans, or nuts.
1 serving of sweets.
6-8 glasses of water.
1 soft drink or cup of coffee daily to limit caffeine.

Standard prenatal vitamins are routinely prescribed for women during pregnancy to ensure that all nutritional requirements are met. Folic acid supplements also are recommended because the average person does not normally consume folic acid in the quantities needed during pregnancy. Folic acid is found in fortified grains, dried beans and leafy greens. Folate supplements should be taken for three months prior to the pregnancy and through the first trimester. The recommended daily allowance for folic acid is 0.2 mg. However, all women of childbearing age are encouraged to take folic acid supplements of 0.4 mg because of the link between neural tube defects with deficient amounts of folic acid. The RDA for pregnancy is 0.4 mg andthe RDA for lactation is 0.2 mg. If the pregnant woman already has a child who has been affected by a neural tube defect, the recommendation is increased to 4 mg a day.

How much weight should I gain during pregnancy?

The infant's birthweight is affected by two major factors; the maternal pre-pregnancy height-for-weight value and weight gain during pregnancy. Weight-for-height value is expressed as the body mass index. The BMI is defined as the weight in kilograms divided by the square of height in meters. to calculate your BMI:

Calculate your height in inches.
Multiply your height in inches by 0.0254 to convert it to meters.
Square your height in meters by multiplying it by itself.
Multiply your weight in pounds by 0.45 to convert it to kilograms.
Divide your weight in kilograms by your squared height in meters.

Here's an example:

5 feet tall is 60 inches (5 feet x 12 inches in a foot).
60 x 0.0254 = 1.524 meters.
1.524 x 1.524 = 2.32 (squared height in meters rounded off).
120 pounds x 0.45 = 54 kilograms.
54 / 2.32 = 23 BMI (rounded off).

BMI categories

Less than 19.8 = underweight

19.8-26 = normal weight

26-29 = overweight

More than 29 = obese

Now that you have calculated your BMI, your weight gain is based on where you fall within the range. A pregnant woman who falls in the underweight BMI category should gain 28-40 pounds. Women of normal weight are advised to gain 25-35 pounds, and overweight or obese women should limit their weight gain to 15-25 pounds.

The majority of weight gain will be in the second and third trimester. However, dieting is never recommended during pregnancy.

Weight gain within these parameters is associated with a lower rate of Caesarean sections, unusually small babies, unusually large babies and postpartum obesity in the mother.

What is preterm labor?

Preterm labor is defined as labor or contractions with cervical changes before 37 weeks' gestation. Preterm labor may lead to delivery of a premature baby. A preterm baby's bodies and organ systems have not been given enough time to mature completely. These babies are at a much higher risk for complications. They are small in size and will often need help with breathing, eating, fighting infection and staying warm. Babies born before 28 weeks' gestation are at the highest risk.

Signs of preterm labor (excluding preterm premature rupture of the membranes) can include:

Contractions (a tightening of the abdomen).
Changes or an increase in vaginal discharge (including fluid or bleeding).
Pressure in your pelvis (feels like the baby is pushing down).
Low, dull back pain.
Menstrual type cramping.
Abdominal cramping with or without diarrhea.

You do not need to experience all of these symptoms to be in preterm labor. If you feel any one of them for more than an hour, call your health care provider or go to the hospital.

If diagnosed early, preterm labor can sometimes be stopped, for even a short time, with bed rest (at home or in the hospital depending on circumstances), extra fluids, and/or medications for the mother (tocolytics to help slow or stop labor). Medications also can be given to the baby to help mature the lungs in case of preterm delivery. Other treatments can include cervical cerclage, which is a minor surgical procedure for women with an incompetent cervix. Cervical incompetence is a physically weak cervix that is unable to stay closed during pregnancy. Antibiotics also may be used to treat an infection if that is the suspected cause of labor. Infections can be a contributing factor to the onset of preterm labor. If all attempt to stop labor fails, the mother's health is at risk or the intrauterine environment is no longer healthy for the baby, the baby will be delivered.

Prolonging a pregnancy even for a few days allows the baby that much more time to mature. Often, the cause of preterm labor is not known. The following factors can increase the risk of preterm birth:

Previous preterm birth.
Multiple gestation (twins or triplets etc).
Previous second trimester abortion(s) or miscarriage(s).
Abnormal cervix or uterus.
Being underweight or overweight.
Smoking.
Use of street drugs or alcohol.
Lack of prenatal care.

What are Braxton Hicks contractions?

Braxton Hicks contractions are sometimes said to be practice contractions. They help to prepare or exercise the uterus for labor and delivery. Braxton Hicks are defined as irregular, non-rhythmical and painless contractions. These can occur as early as 19 – 20 weeks' gestation. The uterus is a muscular organ that can contract any time during the pregnancy, but especially as the baby grows and causes the uterus to enlarge. Often, this type of contraction may not even be felt by the mother. However, as the pregnancy progresses and the uterus gets larger, Braxton Hicks contractions can become more intense or even painful. Braxton Hicks are described as a tightening of the muscles of the uterus that last 30-60 seconds. Dehydration can be a trigger for this type of contraction. Be sure and drink adequate amounts of water if you are experiencing a lot of Braxton Hicks contractions. Also, light activity such as housework (vacuuming or loading groceries) or carrying a toddler may be a trigger for these type of contractions.

Braxton Hicks contractions are sometimes referred to as false labor. Labor is defined as contractions that cause changes in the cervix, including effacement or thinning of the cervix and dilation or opening of the cervix. False labor is a prelude to true labor, and it may be uncomfortable. It usually happens near 40 weeks gestation.

What is false labor?

Below is a comparison of signs and symptoms of false and true labor. False labor can feel like real labor, but the key is that the contractions are not strong enough to cause changes in the cervix. This type of contraction can go on intermittently for days (maybe even a few weeks) before the onset of true labor. Taking warm baths and drinking lots of fluids can sometimes help. The biochemical mechanism that stimulates the onset of labor is not fully understood, but it is thought that labor is perhaps a continuum from Braxton Hicks, to false labor to true labor as your body prepares for delivery. However, if you are less than full term (which is normally defined as 37 weeks gestation and beyond) and you experience any signs of labor, true or false, be sure and see you doctor or midwife right away in order to rule out preterm labor.

True Labor

False Labor

Contractions have a regular pattern.
Contractions become stronger as the interval becomes shorter.
Pain is felt over entire abdomen and may radiate to the back, or pain may start in the back and radiate around to the abdomen.
Pain does not go away when you change your activity.
Pain may slow down but does not go away with medication.
You may discharge bloody mucous.
The water bag may rupture.
Baby's head begins to descend into the birth canal.

Contractions occur at irregular intervals, although there may be periods of regularity.

Contractions not become stronger over time.
Pain is usually more centered in the lower abdomen.
Interval between contractions is varied.
Contractions may go away if you change your activity or with medication.
There are no cervical changes.
The water bag is not ruptured.

Is sexual intercourse safe during pregnancy?

Sexual intercourse is safe for you and your baby unless you have been advised by your health care provider to abstain. As long as your bag of waters is intact and not broken or leaking, your baby is well protected.

If your pregnancy is high risk (your health care provider will tell you if you are high risk) you may be advised to avoid intercourse for all or a portion of the pregnancy. If you have any concerns about intercourse please ask your health care provider if it is OK to have sex.

As your pregnancy progresses, some positions for the mother can be unsafe and uncomfortable. For example, after the fourth month of pregnancy, due to the weight of the growing uterus, most women should not lie flat on their back. This position puts pressure on major blood vessels. Alternatives to the traditional missionary position such as lying on your side or the woman on top is preferable.

However, to avoid sexually transmitted infections, which can be harmful to an unborn baby, having sex with only one person who does not have other partners is recommended. Openly communicate your needs and concerns regarding sexual intimacy with your partner. After the baby is born, it is preferable for you to wait until after your six-week postpartum checkup before you resume intercourse.

What symptoms/issues should I be concerned about?

Call your physician at any time if you are concerned, don't feel "right" or have a question related to your pregnancy. Some specific symptoms that should be brought to your doctor's attention can include but are not limited to:

Vaginal bleeding.
Difficult or labored breathing (different from normal).
Dizziness.
Headache that is severe or won't go away.
Nausea and vomiting that won't go away.
Changes in your vision (blurry or dimmed).
Chest pains.
Sudden and/or significant swelling of your face and hands.
Muscle weakness.
Calf pain or swelling.
Suspect labor has started (pain or cramps in your lower abdomen).
Chills or fever.
Less urine or pain or burning with urination.
Decreased movement of the fetus.
Leakage of fluid from your vagina.

What medications are safe during pregnancy?

Do not take any medication while pregnant without checking with your physician first. Even over-the-counter or non-prescription medications can have damaging effects on a developing fetus. Herbal supplements are classified as dietary supplements by the Food and Drug Administration. The safety and effectiveness of these supplements has not been studied, especially during pregnancy. The quality and strength of an herb can vary greatly between batches and between manufacturers. Large amounts of some herbal teas, including peppermint and red raspberry leaf, are thought to cause uterine contractions. This may increase the risk of miscarriage and/or preterm labor. Other herbs may carry risks as well, so you should discuss any form of supplement with your physician.

What kind of exercise can I do during pregnancy?

In the past, it was thought that pregnancy was a time to sit and put your feet up. However, it has now been discovered that 30 minutes of exercise (every day if possible) reduces the risk of gestational diabetes, burns calories helping to keep weight gain at a more appropriate range, builds stamina needed for labor and delivery, relieves stress and assists in the postpartum period by helping to avoid postpartum depression, regain pre-pregnancy energy levels and lose any extra weight gained during pregnancy.

Before you begin any type of exercise program, be sure and check with your health care provider. They may help you decide which type of exercise would be most appropriate for you.

Some types of exercise that are appropriate for a woman during pregnancy include: walking, dancing, swimming, biking, aerobics (low impact) or yoga.

Activities to avoid include: anything that puts you at risk for injury such as any contact sport, horseback riding, downhill skiing, also avoid exercises that require you to lie flat on your back, and never scuba dive during pregnancy.

When you do exercise, listen and pay attention to your body. Don't overdo it. Be sure and keep yourself well-hydrated. Build up your level of fitness gradually. Stop exercising immediately if you experience any problems such as vaginal bleeding, dizziness, headaches, chest pain, decreased fetal movement or contractions and call your health care provider.

Is there anything to treat morning sickness?

Morning sickness refers to the nausea and vomiting some women experience with pregnancy. It is caused by the hormonal changes that occur during pregnancy. Even though it is called morning sickness, it can occur in the evening or last all day. It tends to go away by the fourth month of pregnancy. Morning sickness does not mean your baby is sick and does not cause any harm to your unborn child. If it becomes so severe that you are unable to keep any food or liquids down, let your doctor know. In rare cases, hospitalization is required to give IV fluids and occasionally nourishment if the mother is unable to eat and drink adequate amounts.

Some tips to help control this problem include:

§ Eat a few crackers before getting up in the morning.

§ Eat several small meals throughout the day so that your stomach is never too full or too empty.

§ Avoid rich, spicy, fried and/or fatty foods.

§ Avoid smelling or eating foods that trigger the nausea.

§ Drink plenty of liquids. Try crushed ice, fruit juice or frozen ice pops if water upsets your stomach. Other fluids to try include gelatin desserts (Jell-O), chicken broths, and ginger ale (non-diet) and decaffeinated sweet or herbal teas.

§ Eat more carbohydrates (plain baked potato, white rice, dry toast).

§ Try acupuncture or motion sickness bands.

§ Try using ginger lozenges.

If these tips don't provide relief discuss your morning sickness with your doctor. He or she may have some more ideas to help with your symptoms.

How much caffeine is safe during pregnancy?

For most pregnant women, two cups of coffee a day is considered safe. However, the issue of caffeine intake is somewhat controversial. Several studies have been done to evaluate the effects of caffeine on birth weight, risk of miscarriage, risk of preterm delivery, fertility and other issues. These studies have been inconclusive in relating caffeine alone to these outcomes. High caffeine intake during pregnancy should be avoided. High intake is defined by some as more than 300 mg and by others as more than 600 mg. A typical cup of brewed coffee will contain approximately 150 mg of caffeine (instant coffee contains less caffeine). An 8-ounce serving of black tea averages 80 mg (green tea contains less). A 12-oz cup of caffeinated soft drink can contain as much as 60 mg of caffeine. Chocolate and cocoa products contain small amounts of caffeine, and some medications may also contain caffeine so be sure and read labels.

Caffeine is a stimulant that enters the nervous system within 15 minutes of consumption. It increases the blood pressure and heart rate slightly. Caffeine also stimulates urination, which will affect a pregnant woman's body's fluid levels. Adequate hydration or fluids in the body is very important for a healthy pregnancy. At least one extra glass of water is recommended for each cup of coffee or caffeine product that is consumed.

What are the risks associated with smoking during pregnancy?

We know that smoking affects not only the mother's health but also her unborn baby's health. Women who smoke are less likely to even become pregnant. When you smoke your baby gets less oxygen. The lack of oxygen can cause your baby to grow more slowly and gain less weight. Smoking can also impair normal fetal brain and nervous system development. A pregnancy compromised by smoking is more likely to result in preterm labor and delivery as well as a low birth weight baby. Smoking during pregnancy has been linked to 10 percent of all infant deaths.

These babies are at an increased risk of dying of sudden infant death syndrome than are those infants whose mother did not smoke. For all these reasons it is very important to quit or cut back. This is also important to your child after he/she is born. Children in a home who breathe secondhand smoke are more prone to respiratory illness, middle ear infections, impaired lung function including asthma and stunted growth.

Tips to Quit include:

Write down your reasons for quitting. Look at the list when you are tempted to smoke.
Choose a "quit day." On that day, throw away all your cigarettes, lighters and ashtrays.
Stay away from places, activities or people that make you feel like smoking.
Ask your partner or a friend to help you quit and call that person when you feel like smoking
Ask your health care provider about quitting aids such as patches, gum, nasal spray and medications. Don't start using these without your health care provider's okay especially if you are pregnant.
Don't get discouraged if you don't quit completely right away. Quitting takes practice. Keep trying. If you can't quit, cut back as much as you can.
Learn about smoking cessation programs in your community. You can get more information from your health care provider, hospital or health department. The organizations listed below can also help:

Should I wear my seatbelt during pregnancy?

Yes. Seatbelts should absolutely be worn during pregnancy. Be sure it is placed low, across the hipbones, and under the pregnant abdomen. The shoulder strap should be placed to the side of the abdomen, between the breasts, and over the mid-portion of the clavicle. No information indicates that air bags are unsafe during pregnancy. Pregnant women should try to keep their abdomen 10 inches away from the sight from which the airbag is ejected.